HS-mGPS评分对进展期胃癌患者化疗效果与生存状况的预测价值
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摘要
目的:探究高敏感格拉斯哥评分(HS-mGPS)对进展期胃癌患者化疗效果与生存状况的预测价值。方法:选取132例进展期胃癌患者为研究对象,所有患者术前接受mFLOFOX6(奥沙利铂、亚叶酸钙及氟尿嘧啶)方案或SOX(奥沙利铂及替吉奥)方案新辅助化疗,依据患者HS-mGPS评分将其分为0分组、1分组和2分组;比较3组患者化疗疗效和生存状况,并单因素和Logistic多因素分析进展期胃癌患者死亡的相关因素。结果:HS-mGPS评分为0分、1分和2分的患者临床有效率分别为75.30%、50.00%和43.47%,组间比较,差异有统计学意义(P<0.05);化疗后6、12、24月时0分组患者的生存率高于1分组和2分组患者,1分组患者生存率均高于2分组,差异具有统计学意义(P<0.05);单因素分析结果显示,术前伴发疾病、肿瘤M分期、T分期、分化程度、组织分型、化疗疗效、组织学反应、术前营养、HS-mGPS评分、消化道重建方式及术者经验与进展期胃癌患者死亡有关(P<0.05);Logistic多因素分析结果显示,M1分期、高T分期、化疗疗效差、组织学反应低级、HS-mGPS评分高、BillrothⅡ式吻合术及术者经验≤5年为进展期胃癌患者死亡的危险因素(P<0.05)。结论:HS-mGPS得分低的进展期胃癌患者化疗疗效与术后生存状况优于得分高的患者, HS-mGPS评分对进展期胃癌患者化疗效果有预测价值。
Objective: To explore the predictive value of high sensitive modified Glasgow prognostic score(HS-mGPS) for the chemotherapy effect and survival status of patients with advanced gastric cancer. Methods: A total of 132 patients with advanced gastric cancer in our hospital from June 2015 to June 2016 were selected. All patients received mFLOFOX6(Oxaliplatin, leucovorin, fluorouracil) or SOX(Saliplatin and Ticao) before surgery. They were divided into the 0-point group, the 1-point group, and the 2-point group according to the patient's HS-mGPS scores. The curative effect and survival status of the 3 groups were compared, and the single factor and Logistic multivariate analysis were used toobserve the related factors of death in patients with advanced gastric cancer. Results: The clinical response rates of patients with 0, 1 and 2 points of HS-mGPS scores were 75.30%, 50.00% and 43.47% respectively. 6, 12, 24 months after chemotherapy, the survival rate of the 0-point group was higher than that of other 2 groups, and the survival rate of the 1-point group was higher than that of the 2-point group. The difference was statistically significant(P<0.05). Univariate analysis showed preoperative disease, tumor M stage, T stage, differentiation, tissue classification, chemotherapy efficacy, histological response, preoperative nutrition, HS-mGPS score, digestive tract reconstruction, and surgeon experience. It was closely related to the death of patients with advanced gastric cancer(P<0.05). Logistic multivariate analysis showed that M1 stage, high T stage, poor chemotherapy efficacy, low histological response, high HS-mGPS scores, Billroth II anastomosis, and surgeon experience≤5 years were risk factors for the death of patients with advanced gastric cancer(P<0.05).Conclusion: The efficacy of chemotherapy for HS-mGPS and advanced gastric cancer patients is related to the postoperative survival status. Patients with high HS-mGPS scores have lower clinical efficiency of chemotherapy and lower postoperative survival rate. HS-mGPS scores can be applied to the progress in clinical practice, predicting the clinical efficacy and survival of patients with gastric cancer.
Objective: To explore the predictive value of high sensitive modified Glasgow prognostic score(HS-mGPS) for the chemotherapy effect and survival status of patients with advanced gastric cancer. Methods: A total of 132 patients with advanced gastric cancer in our hospital from June 2015 to June 2016 were selected. All patients received mFLOFOX6(Oxaliplatin, leucovorin, fluorouracil) or SOX(Saliplatin and Ticao) before surgery. They were divided into the 0-point group, the 1-point group, and the 2-point group according to the patient's HS-mGPS scores. The curative effect and survival status of the 3 groups were compared, and the single factor and Logistic multivariate analysis were used toobserve the related factors of death in patients with advanced gastric cancer. Results: The clinical response rates of patients with 0, 1 and 2 points of HS-mGPS scores were 75.30%, 50.00% and 43.47% respectively. 6, 12, 24 months after chemotherapy, the survival rate of the 0-point group was higher than that of other 2 groups, and the survival rate of the 1-point group was higher than that of the 2-point group. The difference was statistically significant(P<0.05). Univariate analysis showed preoperative disease, tumor M stage, T stage, differentiation, tissue classification, chemotherapy efficacy, histological response, preoperative nutrition, HS-mGPS score, digestive tract reconstruction, and surgeon experience. It was closely related to the death of patients with advanced gastric cancer(P<0.05). Logistic multivariate analysis showed that M1 stage, high T stage, poor chemotherapy efficacy, low histological response, high HS-mGPS scores, Billroth II anastomosis, and surgeon experience≤5 years were risk factors for the death of patients with advanced gastric cancer(P<0.05).Conclusion: The efficacy of chemotherapy for HS-mGPS and advanced gastric cancer patients is related to the postoperative survival status. Patients with high HS-mGPS scores have lower clinical efficiency of chemotherapy and lower postoperative survival rate. HS-mGPS scores can be applied to the progress in clinical practice, predicting the clinical efficacy and survival of patients with gastric cancer.
引文
[1] 孟燕,曹凤军,陈萍,等.补中益气汤加减联合化疗治疗胃癌术后50例[J].环球中医药,2015,8(8):995-997.
[2] 任芳华,王思雨,蔡骏,等.不同营养状态胃肠肿瘤患者中医客观化舌象特征探究[J].环球中医药,2016,9(9):1033-1037.
[3] 沈玉美.XELOX方案术前化疗联合心理干预对进展期胃癌手术治疗效果的影响[J].中国生化药物杂志,2017,11(7):174-175.
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[8] 胡时栋,邹贵军,邹振玉,等.术前化疗对晚期胃癌患者R0切除的影响[J].临床外科杂志,2017,25(2):131-134.
[9] 谢荃沁,陈陆俊,蒋敬庭,等.RDW联合mGPS评分对原发性肝癌诊断及预后意义[J].中国医药生物技术,2016,11(2):116-122.
[10]范俊,李佽,邢莎莎,等.术前炎症相关标记物对结直肠癌根治术后预后影响的研究[J].中华临床医师杂志,2016,10(5):607-614.
[11]马燕凌,孙建海,刘莉,等.改良基线格拉斯哥评分与晚期结直肠癌患者近期疗效相关性分析[J].陕西医学杂志,2017,46(3):336-337.
[12]马雄辉,林琳,郑继川,等.局部晚期胃癌术前同期放化疗的临床疗效[J].广东医学,2017,38(3):390-393.
[13]冯玲玲,张玉晶,张黎,等.胃癌术前放化疗正常组织放射损伤的剂量效应分析[J].中华放射肿瘤学杂志,2018,27(3):271-276.
[14]NAKAMURA T,MATSUMINE A,ASANUMA K,et al.The value of the high-sensitivity modified Glasgow prognostic score in predicting the survival of patients with a soft-tissue sarcoma[J].The Journal of Bone and Joint Surgery,2015,97(6):847-852.
[15]INOUE D,OZAKA M,MATSUYAMA M,et al.Prognostic value of neutrophil-lymphocyte ratio and level of C-reactive protein in a large cohort of pancreatic cancer patients:a retrospective study in a single institute in Japan[J].Japanese Journal of Clinical Oncology,2015,45(1):61-66.
[16]TAKENO S,HASHIMOTO T,SHIBATA R,et al.The high-sensitivity modified Glasgow prognostic score is superior to the modified Glasgow prognostic score as a prognostic predictor in patients with resectable gastric cancer[J].Oncology,2014,87(4):205-214.
[17]CRUMLEY A B,STUART R C,MCKERNAN M,et al.Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG-ps) in patients receiving palliative chemotherapy for gastroesophageal cancer[J].J Gastroenterol Hepatol,2008,23(8 Pt 2):e325-e329.
[18]WANG D,DUAN L,TU Z,et al.The Glasgow prognostic score predicts response to chemotherapy in patients with metastatic breast cancer[J].Chemotherapy,2016,61(4):217-222.
[19]CRUMLEY A B,STUART R C,MCKERNAN M,et al.Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG-ps) in patients receiving palliatice chemotherapy for gastroesophageal cancer[J].J Gastroenterol Hepatol,2008,23(8):e325-e329.
[2] 任芳华,王思雨,蔡骏,等.不同营养状态胃肠肿瘤患者中医客观化舌象特征探究[J].环球中医药,2016,9(9):1033-1037.
[3] 沈玉美.XELOX方案术前化疗联合心理干预对进展期胃癌手术治疗效果的影响[J].中国生化药物杂志,2017,11(7):174-175.
[4] 张峻,王跃,赵岩,等.肠外营养支持对胃癌新辅助化疗病人围术期营养状态和免疫功能的影响[J].肠外与肠内营养,2017,24(4):209-212.
[5] ZHOU T,HONG S D,HU Z H,et al.A systemic inflammation-based prognostic scores (mGPS) predicts overall survival of patients with small-cell lung cancer[J].Tumour biology:the journal of the International Society for Oncodevelopmental Biology and Medicine,2015,36(1):337-343.
[6] PROCTOR M J,HORGAN P G,TALWAR D,et al.Optimization of the systemic inflammation-based Glasgow Prognostic Score[J].Cancer,2013,119(12):2325-2332.
[7] 胡洪亮.益气健脾抗癌汤联合化疗治疗胃癌41例[J].环球中医药,2016,9(8):996-998.
[8] 胡时栋,邹贵军,邹振玉,等.术前化疗对晚期胃癌患者R0切除的影响[J].临床外科杂志,2017,25(2):131-134.
[9] 谢荃沁,陈陆俊,蒋敬庭,等.RDW联合mGPS评分对原发性肝癌诊断及预后意义[J].中国医药生物技术,2016,11(2):116-122.
[10]范俊,李佽,邢莎莎,等.术前炎症相关标记物对结直肠癌根治术后预后影响的研究[J].中华临床医师杂志,2016,10(5):607-614.
[11]马燕凌,孙建海,刘莉,等.改良基线格拉斯哥评分与晚期结直肠癌患者近期疗效相关性分析[J].陕西医学杂志,2017,46(3):336-337.
[12]马雄辉,林琳,郑继川,等.局部晚期胃癌术前同期放化疗的临床疗效[J].广东医学,2017,38(3):390-393.
[13]冯玲玲,张玉晶,张黎,等.胃癌术前放化疗正常组织放射损伤的剂量效应分析[J].中华放射肿瘤学杂志,2018,27(3):271-276.
[14]NAKAMURA T,MATSUMINE A,ASANUMA K,et al.The value of the high-sensitivity modified Glasgow prognostic score in predicting the survival of patients with a soft-tissue sarcoma[J].The Journal of Bone and Joint Surgery,2015,97(6):847-852.
[15]INOUE D,OZAKA M,MATSUYAMA M,et al.Prognostic value of neutrophil-lymphocyte ratio and level of C-reactive protein in a large cohort of pancreatic cancer patients:a retrospective study in a single institute in Japan[J].Japanese Journal of Clinical Oncology,2015,45(1):61-66.
[16]TAKENO S,HASHIMOTO T,SHIBATA R,et al.The high-sensitivity modified Glasgow prognostic score is superior to the modified Glasgow prognostic score as a prognostic predictor in patients with resectable gastric cancer[J].Oncology,2014,87(4):205-214.
[17]CRUMLEY A B,STUART R C,MCKERNAN M,et al.Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG-ps) in patients receiving palliative chemotherapy for gastroesophageal cancer[J].J Gastroenterol Hepatol,2008,23(8 Pt 2):e325-e329.
[18]WANG D,DUAN L,TU Z,et al.The Glasgow prognostic score predicts response to chemotherapy in patients with metastatic breast cancer[J].Chemotherapy,2016,61(4):217-222.
[19]CRUMLEY A B,STUART R C,MCKERNAN M,et al.Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG-ps) in patients receiving palliatice chemotherapy for gastroesophageal cancer[J].J Gastroenterol Hepatol,2008,23(8):e325-e329.