改良格拉斯哥预后评分预测晚期胰腺癌预后的临床价值

doi:10.16689/j.cnki.cn11-9349/r.2020.04.012

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (536 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨改良格拉斯哥预后评分（mGPS）对晚期胰腺癌患者生存的影响，评估其在晚期胰腺癌预后中的潜在临床价值。方法回顾性分析2015年1月至2018年12月南京医科大学第一附属医院肿瘤内科及消化内科治疗的56例晚期胰腺癌的临床资料。分析mGPS及临床特征与患者预后的关系，采用 Kaplan-Meier法绘制生存曲线，log-rank 进行单因素分析，Cox比例风险模型进行多因素分析影响晚期胰腺癌患者不良预后的预后因素。结果56例患者中男性32例，女性24例，mGPS评分0分、1分、2分患者分别为29例、21例、6例。单因素分析显示年龄≥65岁（P=0.035）、mGPS评分高（P<0.001）、未接受化疗（P<0.001）为影响晚期胰腺癌患者总生存期的危险因素，进一步Cox多因素回归分析提示年龄≥65岁（P=0.021）、mGPS评分为2分（P<0.001）、未接受化疗（P<0.001）为晚期胰腺癌独立预后不良因素。结论mGPS在评估晚期胰腺癌患者的预后中具有重要的临床意义，mGPS评分高提示预后不良。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	刘怡茜
	王健
	刘凌翔
	束永前

关键词 ：胰腺癌, 改良格拉斯哥预后评分, 治疗结果, 预后

Abstract：ObjectiveTo investigate the effect of modified Glasgow prognosis score (mGPS) on the survival of patients with advanced pancreatic cancer, and to evaluate its potential clinical value in the prognosis of advanced pancreatic cancer. MethodsThe clinical data of 56 patients with advanced pancreatic cancer treated in the Department of oncology and gastroenterology, the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2018 were retrospectively analyzed. The relationship between mGPS, clinical features and prognosis was analyzed. Kaplan Meier method was used to draw survival curve, log-rank was used for univariate analysis, and Cox proportional hazard model was used for multivariate analysis to analyze the prognostic factors affecting poor prognosis of patients with advanced pancreatic cancer. Results Among the 56 patients, 32 were male and 24 were female. There were 29, 21 and 6 patients with mGPS score of 0, 1 and 2 respectively. Univariate analysis showed that age ≥ 65 years (P=0.035), high mGPS score (P<0.001) and no chemotherapy (P<0.001) were risk factors for OS in patients with advanced pancreatic cancer. Further multivariate Cox regression analysis showed that age ≥ 65 years (P=0.021), mGPS score of 2 (P<0.001) and non chemotherapy (P<0.001) were independent poor prognostic factors of advanced pancreatic cancer. Conclusion mGPS has important clinical significance in evaluating the prognosis of patients with advanced pancreatic cancer. High mGPS score indicates poor prognosis.

Key words： Pancreatic cancer Modified Glasgow prognostic score Treatment outcome Prognosis

基金资助:国家重点研发计划项目（2017YFC1309201）

通讯作者: 束永前，电子邮箱：shuyongqian@csco.org.cn ·论著·

引用本文:

刘怡茜，王健，刘凌翔，束永前. 改良格拉斯哥预后评分预测晚期胰腺癌预后的临床价值[J]. 肿瘤代谢与营养电子杂志, 2020, 7(4): 438-442.
Liu Yiqian,Wang Jian,Liu Lingxiang, Shu Yongqian. The clinical value of modified Glasgow prognosis score in predicting the prognosis of advanced pancreatic cancer. Electron J Metab Nutr Cancer, 2020, 7(4): 438-442.

1.BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］. CA Cancer J Clin, 2018, 68(6): 394-424.
2.RAHIB L, SMITH B D, AIZENBERG R, et al. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States［J］. Cancer Res, 2014, 74(11): 2913-2921.
3.VINCENT A, HERMAN J, SCHULICK R, et al. Pancreatic cancer［J］. Lancet, 2011, 378(9791): 607-620.
4.MANTOVANI A, ALLAVENA P, SICA A, et al. Cancer-related inflammation［J］. Nature, 2008, 454(7203): 436-444.
5.JAMIESON N B, DENLEY S M, LOGUE J, et al. A prospective comparison of the prognostic value of tumor- and patient-related factors in patients undergoing potentially curative surgery for pancreatic ductal adenocarcinoma［J］. Ann Surg Oncol, 2011, 18(8): 2318-2328.
6.KANDA M, FUJII T, KODERA Y, et al. Nutritional predictors of postoperative outcome in pancreatic cancer［J］. Br J Surg, 2011, 98(2): 268-274.
7.SZKANDERA J, GERGER A, LIEGL-ATZWANGER B, et al. The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas［J］. Int J Cancer, 2014, 135(2): 362-370.
8.WANG D S, REN C, QIU M Z, et al. Comparison of the prognostic value of various preoperative inflammation-based factors in patients with stage Ⅲ gastric cancer［J］. Tumour Biol, 2012, 33(3): 749-756.
9.MCMILLAN D C. An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer［J］. Proc Nutr Soc, 2008, 67(3): 257-262.
10.FORREST L M, MCMILLAN D C, MCARDLE C S, et al. A prospective longitudinal study of performance status, an inflammation-based score (GPS) and survival in patients with inoperable non-small-cell lung cancer［J］. Br J Cancer, 2005, 92(10): 1834-1836.
11.CRUMLEY A B, MCMILLAN D C, MCKERNAN M, et al. Evaluation of an inflammation-based prognostic score in patients with inoperable gastro-oesophageal cancer［J］. Br J Cancer, 2006, 94(5): 637-641.
12.ROXBURGH C S, PLATT J J, LEITCH E F, et al. Relationship between preoperative comorbidity, systemic inflammatory response, and survival in patients undergoing curative resection for colorectal cancer［J］. Ann Surg Oncol, 2011, 18(4): 997-1005.
13.PROCTOR M J, MORRISON D S, TALWAR D, et al. An inflammation-based prognostic score (mGPS) predicts cancer survival independent of tumour site: a glasgow inflammation outcome study［J］. Br J Cancer, 2011, 104(4): 726-734.
14.MATSUMOTO I, KAMEI K, OMAE K, et al. FOLFIRINOX for locally advanced pancreatic cancer: Results and prognostic factors of subset analysis from a nation-wide multicenter observational study in Japan［J］. Pancreatology, 2019, 19(2): 296-301.
15.CAMERON J L, RIALL T S, COLEMAN J, et al. One thousand consecutive pancreaticoduodenectomies［J］. Ann Surg, 2006, 244(1): 10-15.
16.FORREST L M, MCMILLAN D C, MCARDLE C S, et al. Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer［J］. Br J Cancer, 2004, 90(9): 1704-1706.
17.GLEN P, JAMIESON N B, MCMILLAN D C, et al. Evaluation of an inflammation-based prognostic score in patients with inoperable pancreatic cancer［J］. Pancreatology, 2006, 6(5): 450-453.
18.MCMILLAN D C. The systemic inflammation-based Glasgow prognostic score: a decade of experience in patients with cancer［J］. Cancer Treat Rev, 2013, 39(5): 534-540.
19.COUSSENS L M, WERB Z. Inflammation and cancer［J］. Nature, 2002, 420(6917): 860-867.
20.CRUMLEY A B, STUART R C, MCKERNAN M, et al. Is hypoalbuminemia an independent prognostic factor in patients with gastric cancer?［J］. World J Surg, 2010, 34(10): 2393-2398.
21.LIEN Y C, HSIEH C C, WU Y C, et al. Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia［J］. J Gastrointest Surg, 2004, 8(8): 1041-1048.
22.GRIVENNIKOV S I, GRETEN F R, KARIN M. Immunity, inflammation, and cancer［J］. Cell, 2010, 140(6): 883-899.
23.ELINAV E, NOWARSKI R, THAISS C A, et al. Inflammation-induced cancer: crosstalk between tumours, immune cells and microorganisms［J］. Nat Rev Cancer, 2013, 13(11): 759-771.
24.MCKEOWN D J, BROWN D J, KELLY A, et al. The relationship between circulating concentrations of C-reactive protein, inflammatory cytokines and cytokine receptors in patients with non-small-cell lung cancer［J］. Br J Cancer, 2004, 91(12): 1993-1995.
25.KISHI T, NAKAMURA A, ITASAKA S, et al. Pretreatment C-reactive protein level predicts outcome and patterns of failure after chemoradiotherapy for locally advanced pancreatic cancer［J］. Pancreatology, 2015, 15(6): 694-700.
26.FANALI G, DI MASI A, TREZZA V, et al. Human serum albumin: from bench to bedside［J］. Mol Aspects Med, 2012, 33(3): 209-290.
27.LOHSIRIWAT V, LOHSIRIWAT D, BOONNUCH W, et al. Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery［J］. World J Gastroenterol, 2008, 14(8): 1248-1251.
28.PINATO D J, NORTH B V, SHARMA R. A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: the prognostic nutritional index (PNI)［J］. Br J Cancer, 2012, 106(8): 1439-1445.
29.YAMADA S, FUJII T, YABUSAKI N, et al. Clinical implication of inflammation-based prognostic score in pancreatic cancer: Glasgow Prognostic score is the most reliable parameter［J］. Medicine (Baltimore), 2016, 95(18): e3582.
30.IINO C, SHIMOYAMA T, IGARASHI T, et al. Biliary drainage improves the predictive value of modified Glasgow Prognostic Scores in inoperable pancreatic cancer［J］. PLoS One, 2017, 12(6): e0178777.
31.IMAOKA H, MIZUNO N, HARA K, et al. Evaluation of Modified Glasgow Prognostic Score for pancreatic cancer: a retrospective cohort study［J］. Pancreas, 2016, 45(2): 211-217.
32.LA TORRE M, NIGRI G, CAVALLINI M, et al. The glasgow prognostic score as a predictor of survival in patients with potentially resectable pancreatic adenocarcinoma［J］. Ann Surg Oncol, 2012, 19(9): 2917-2923.