古斯塔夫·鲁西免疫评分（GRImScore）作为Ⅲ期胃癌患者的新型预后指标：一项真实世界回顾性研究
Gustave Roussy Immune Score (GRImScore) as a Novel Prognostic Index for Stage III Gastric Cancer Patients: A Real-World Retrospective Study.
作者信息
Zhao Xiaofeng, Zhang Fen, Xing Panpan, Jiang Chunyan, Li Danqing, Wu Dianchao
机构信息
Department of Gastrointestinal Tumor Surgery, Xingtai People's Hospital, Xingtai, Hebei, 054001, People's Republic of China.
Department of Radiotherapy, Xingtai People's Hospital, Xingtai, Hebei, 054001, People's Republic of China.
出版信息
Int J Gen Med. 2025 Jun 24;18:3373-3391. doi: 10.2147/IJGM.S515795. eCollection 2025.
OBJECTIVE
This study aimed to investigate whether Gustave Roussy immune score (GRImScore) serves as a novel prognostic index for predicting survival in patients with advanced gastric cancer.
METHODS
GRImScore was based on three objective markers: (1) albumin level (<3.5 g/L = 1 point, ≥3.5 g/L = 0 point); (2) lactate dehydrogenase level (≥250 U/L = 1 point, <250 U/L = 0 point); (3) neutrophil to lymphocyte ratio (NLR) (≥2.70 = 1 point, <2.70 = 0 point). According to GRImScore, these patients were divided into low GRImScore group (0 points) and high GRImScore group (1, 2, or 3 points). Kaplan-Meier method was applied to draw survival curves for disease free survival (DFS) and overall survival (OS), and differences among these groups were analyzed using Log rank tests. Univariate and multivariate Cox proportional hazards models were used to analyze the relationship between the enrolled parameters and OS. Nomograms were developed based on the results of multivariate Cox regression analysis using the consistency index (C-index) and decision curve analyses (DCA) for internal validation.
RESULTS
Based on GRImScore, 134 patients were in low GRImScore group and 61 were in high GRImScore group. The median DFS and OS in low GRImScore group were significantly longer than that in high GRImScore group (DFS: 40.52 months vs 22.83 months, χ=7.033, =0.0080; OS: 55.07 months vs 31.83 months, χ=6.328, =0.0119). According to multivariable Cox analysis, GRImScore was significantly associated with DFS (HR, 2.798; 95% CI: 1.711-11.008, = 0.001) and OS (HR, 2.631; 95% CI: 1.645-10.725, = 0.001). The nomogram constructed by multivariate Cox analysis showed good performance in predicting DFS (C-index: 0.717, 95% CI: 0.595-0.814) and OS (C-index: 0.725, 95% CI: 0.605-0.819).
CONCLUSION
GRImScore, a novel prognostic index, is a prognostic indicator for patients with advanced gastric cancer. Nomograms based on the GRImScore showed good predictive ability.
目的
本研究旨在探讨古斯塔夫·鲁西免疫评分（GRImScore）是否可作为预测晚期胃癌患者生存的新型预后指标。
方法
GRImScore基于三个客观指标：（1）白蛋白水平（<3.5 g/L = 1分，≥3.5 g/L = 0分）；（2）乳酸脱氢酶水平（≥250 U/L = 1分，<250 U/L = 0分）；（3）中性粒细胞与淋巴细胞比值（NLR）（≥2.70 = 1分，<2.70 = 0分）。根据GRImScore，将这些患者分为低GRImScore组（0分）和高GRImScore组（1、2或3分）。采用Kaplan-Meier法绘制无病生存期（DFS）和总生存期（OS）的生存曲线，并使用对数秩检验分析这些组之间的差异。单因素和多因素Cox比例风险模型用于分析纳入参数与OS之间的关系。基于多因素Cox回归分析结果，使用一致性指数（C-index）和决策曲线分析（DCA）进行内部验证，构建列线图。
结果
基于GRImScore，134例患者为低GRImScore组，61例为高GRImScore组。低GRImScore组的中位DFS和OS显著长于高GRImScore组（DFS：40.52个月对22.83个月，χ=7.033，=0.0080；OS：55.07个月对31.83个月，χ=6.328，=0.0119）。根据多因素Cox分析，GRImScore与DFS（HR，2.798；95%CI：1.711-11.008，=0.001）和OS（HR，2.631；95%CI：1.645-10.725，=0.001）显著相关。多因素Cox分析构建的列线图在预测DFS（C-index：0.717，95%CI：0.595-0.814）和OS（C-index：0.725，95%CI：0.605-0.819）方面表现良好。
结论
GRImScore作为一种新型预后指标，是晚期胃癌患者的预后指标。基于GRImScore的列线图显示出良好的预测能力。
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