格拉斯哥评分与腹腔镜胃癌根治术患者生存时间及临床病理参数的关系

Association of Glasgow prognostic score with survival time after laparoscopy-assisted gastrectomy for gastric cancer and clinicopathological parameters

目的:评估格拉斯哥评分与胃癌患者生存时间及临床病理参数之间的关系。方法:回顾分析2012～2017年为92例胃癌患者行腹腔镜胃癌根治术的临床资料。采用卡方检验评估胃癌格拉斯哥评分与临床病理参数间的关系,KaplanMeier法对生存情况进行分析,生存曲线差异使用log-rank检验。预后相关因素分析采用Cox比例风险模型,P<0.05表示差异有统计学意义。结果:格拉斯哥评分增加与肿瘤生物学的侵袭性相关,如肿瘤浸润程度(χ~2=80.61,P<0.05)、远处转移(χ~2=82.31,P<0.01)、脉管浸润(χ~2=38.89,P<0.01)、降低的总体生存率(P<0.05)及围手术期并发症(χ~2=92.31,P<0.01),其中位生存时间为23.1个月。格拉斯哥评分是总体生存率的独立预后参数(风险比为1.6,95%可信区间为1.0～2.4,P<0.05)。结论:格拉斯哥评分是胃癌患者术后长期结局独立的预后参数,建议用于胃癌患者的常规术前评估。

Objective:To evaluate the association between Glasgow prognostic score(GPS)and survival time and clinicopathological parameters in gastric cancer patients.Methods:Patients with gastric cancer who underwent laparoscopy-assisted gastrectomy between 2012 and 2017 were retrospectively analyzed.GPS was estimated based on the preoperative measurement of C-reactive protein and serum albumin levels.The relationship between GPS and other clinicopathological parameters were analyzed using Chi-square test.Sur vival analysis was established according to the Kaplan-Meier method and survival curves were compared by the log-rank test.Multivariate analysis to assess the role of GPS and the other clinicopathological parameters as prognostic factors were performed by the Cox regression analysis.P values less than 0.05 were considered to be statistically significant.Results:Increasing GPS was linked to aggressive tumor biology in terms of pT stages(χ^2=80.61,P<0.05),synchronous distant metastases(χ^2=82.31,P<0.01),venous vessel invasion(χ^2=38.89,P<0.01),reduced overall survival(P<0.05)and perioperative complications(χ^2=92.31,P<0.01)with median overall survival in the whole cohort being 23.1 months.GPS was identified as an independent prognosticator of overall survival(HR=1.6,95%CI:1.0-2.4,P<0.05).Conclusions:GPS represents an independent prognostic factor for long-term outcome in resected gastric cancer patients and should be included in the routine preoperative assessment of all surgically treated gastric cancer patients.