改良型格拉斯哥预后评分对肝门部胆管癌患者手术治疗预后评估的价值研究
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摘要
目的探讨术前改良型格拉斯哥预后评分(mGPS)对肝门部胆管癌患者手术治疗预后的评估价值。方法回顾性分析接受根治性外科手术治疗的64例肝门部胆管癌患者的临床资料,根据患者术前血C反应蛋白(CRP)和白蛋白(Alb)水平进行mGPS,并将患者分为mGPS 0分组(33例)、mGPS 1分组(21例)、mGPS 2分组(10例)。比较3组患者临床特征、术前实验室检查结果、术后生存情况。结果 3组患者性别、年龄、肿瘤分型、术前TBil、AFP、CA19-9、TNM分期及分化程度比较均无统计学差异(均P>0.05),术前CRP、Alb水平比较差异有统计学意义(均P<0.05)。mGPS 0分组、mGPS 1分组、mGPS 2分组患者术后中位生存时间分别为33.6、27.1、22.6个月,中位无进展生存时间为32.3、23.4、16.5个月;mGPS 2分组患者术后3年生存率(24.30%)低于mGPS 0分组(65.59%)、mGPS 1分组(54.37%)(均P<0.05)。结论 mGPS可用于评估肝门部胆管癌患者手术治疗的预后,评分越高,预后越差。
Objective To assess the application of modified Glasgow prognostic score(mGPS) in predicting postoperative survival of patients with cholangiocarcinoma. Methods Clinical data of 64 patients with hilar cholangiacarcinoma undergoing radical resection were retrospectively analyzed. Patients were evaluated with mGPS based on the elevated values of preoperative C-reactive protein(CRP>10 mg/L) and albumin(Alb <35 g/L). There were 33 cases with mGPS 0, 21 cases with mGPS 2 and 10 cases with mGPS 2. The clinical features, laboratory tests and postoperative survival were compared among three groups.Results There were no statistically significant differences in sex, age, tumor types, preoperative TBil, AFP, CA19-9, TNM stages and tumor differentiation among 3 groups(P >0.05); while there was significant difference in preoperative CRP and ALB levels(P <0.05). The median overall survival of patients with mGPS 0, mGPS 1 and mGPS 2 was 33.6, 27.1 and 22.6 months,respectively(P<0.05); the median progress-free survival of three groups was 32.3, 23.4, and 16.5 months, respectively(P<0.05).The 3-years survival rate of patients with mGPS 2(24.3%) was significantly lower than that of patients with mGPS 0(65.59%) and those with mGPS 1(54.37%, P<0.05). Conclusion Preoperative mGPS can be used to evaluate the prognosis in patients with hilar cholangiocarcinoma after radical surgery.
Objective To assess the application of modified Glasgow prognostic score(mGPS) in predicting postoperative survival of patients with cholangiocarcinoma. Methods Clinical data of 64 patients with hilar cholangiacarcinoma undergoing radical resection were retrospectively analyzed. Patients were evaluated with mGPS based on the elevated values of preoperative C-reactive protein(CRP>10 mg/L) and albumin(Alb <35 g/L). There were 33 cases with mGPS 0, 21 cases with mGPS 2 and 10 cases with mGPS 2. The clinical features, laboratory tests and postoperative survival were compared among three groups.Results There were no statistically significant differences in sex, age, tumor types, preoperative TBil, AFP, CA19-9, TNM stages and tumor differentiation among 3 groups(P >0.05); while there was significant difference in preoperative CRP and ALB levels(P <0.05). The median overall survival of patients with mGPS 0, mGPS 1 and mGPS 2 was 33.6, 27.1 and 22.6 months,respectively(P<0.05); the median progress-free survival of three groups was 32.3, 23.4, and 16.5 months, respectively(P<0.05).The 3-years survival rate of patients with mGPS 2(24.3%) was significantly lower than that of patients with mGPS 0(65.59%) and those with mGPS 1(54.37%, P<0.05). Conclusion Preoperative mGPS can be used to evaluate the prognosis in patients with hilar cholangiocarcinoma after radical surgery.
引文
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[3]Campbell J,Mcpeake J,Shaw M,et al.Validation and analysis of prognostic scoring systems for critically ill patients with cirrhosis admitted to ICU[J].Critical Care,2015,19(1):364.
[4]李金海,翟华伟,孙广正,等.格拉斯哥预后评分对胰腺癌患者术后生存及预后评估[J].中华肝胆外科杂志,2014,20(10):750-752.
[5]Lee PT,Bird S,Zou J,et al.Phylogeny and expression analysis of C-reactive protein(CRP)and serum amyloid-P(SAP)like genes reveal two distinct groups in fish[J].Fish Shellfish Immunol,2017,65(1):42-51.
[6]陈茜娜,蔡小核,陈清,等.脐血PCT、CRP水对具有感染高因素晚期早产儿早发感染的诊断价值[J].浙江医学,39(6):478-479.
[7]ShibutaniM,Maeda K,Nagahara H,et al.The significance of the C-reactive protein to albumin ratio as a marker for predicting survival and monitoring chemotherapeutic effectiveness in patients with unresectable metastatic colorectal cancer[J].Springerplus,2016,5(1):1798.
[8]Xiao Y,Ren YK,Cheng HJ,et al.Modified Glasgow prognostic score is an independent prognostic factor in patients with cervical cancer undergoing chemoradiotherapy[J].International Journal of Clinical&Experimental Pathology,2015,8(5):5273-5281.
[9]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.