Matsui Ryota, Nunobe Souya, Ri Motonari, Makuuchi Rie, Irino Tomoyuki, Hayami Masaru, Ohashi Manabu, Sano Takeshi
Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
Cancers (Basel). 2024 Nov 20;16(22):3889. doi: 10.3390/cancers16223889.
: This study aimed to determine whether the prealbumin prognostic score (PPS), a novel indicator using prealbumin instead of albumin in the modified Glasgow Prognostic Score (mGPS), is a better predictive marker postoperatively in patients with gastric cancer. : This retrospective study included consecutive patients who underwent radical gastrectomy for primary pStages I-III gastric cancer between 2006 and 2017. The cutoff values for preoperative prealbumin and C-reactive protein (CRP) were 22 mg/dL and 0.5 mg/dL, respectively. According to the prealbumin and CRP levels, a PPS of zero was defined as both being above the cutoff value, of one as either being below the cutoff value, and of two as both being below the cutoff value. : Of the 4663 patients, 3421 (73.4%) had a score of zero, 984 (21.1%) had a score of one, and 258 (5.5%) had a score of two. The higher the PPS, the poorer the overall survival [OS] ( < 0.001). When comparing OS by the PPS in patients with an mGPS of zero, a PPS of one indicated poorer OS than a PPS of zero ( < 0.001). In the multivariate analysis, PPSs of one (hazard ratio [HR]: 1.603; 95% confidence interval [CI]: 1.378-1.866; < 0.001) and two (HR: 1.322; 95% CI: 1.055-1.656; = 0.015) were independent poor prognostic factors for OS. : The PPS, which is based on a combination of prealbumin and CRP levels, can identify a wider range of patients with poor OS than mGPS in patients with gastric cancer after gastrectomy.
本研究旨在确定前白蛋白预后评分（PPS），即在改良格拉斯哥预后评分（mGPS）中使用前白蛋白而非白蛋白的一种新型指标，是否是胃癌患者术后更好的预测标志物。本回顾性研究纳入了2006年至2017年间因I - III期原发性胃癌接受根治性胃切除术的连续患者。术前前白蛋白和C反应蛋白（CRP）的临界值分别为22mg/dL和0.5mg/dL。根据前白蛋白和CRP水平，PPS为零定义为两者均高于临界值，为一定义为其中之一低于临界值，为二定义为两者均低于临界值。在4663例患者中，3421例（73.4%）评分为零，984例（21.1%）评分为一，258例（5.5%）评分为二。PPS越高，总生存期（OS）越差（P<0.001）。在mGPS为零的患者中比较PPS的OS时，PPS为一表明OS比PPS为零差（P<0.001）。在多变量分析中，PPS为一（风险比[HR]：1.603；95%置信区间[CI]：1.378 - 1.866；P<0.001）和为二（HR：1.322；95%CI：1.055 - 1.656；P = 0.015）是OS的独立不良预后因素。基于前白蛋白和CRP水平组合的PPS，在胃癌胃切除术后患者中比mGPS能识别出更广泛的OS较差患者。
