改良格拉斯哥预后评分评估肺癌患者预后价值的研究

The prognostic value of modified Glasgow Prognostic Score in lung cancer patients

目的探索改良格拉斯哥预后评分(modified Glasgow prognostic score,mGPS)评估肺癌患者预后的价值。方法回顾性分析2008年8月-2013年5月在四川大学华西医院初次确诊的肺癌患者临床资料和随访信息。应用mGPS对患者预后进行评分,采用Kaplan-Meier法和对数秩检验比较不同mGPS评分患者的总生存期(overall survival,OS)的差异,应用单因素和多因素Cox比例风险模型计算风险比(hazard ratio,HR)及95%置信区间(confidence interval,CI),评估不同指标对肺癌患者预后的影响。结果共纳入患者289例,其中mGPS为0、1、2分的患者分别有127、90、72例。mGPS 0分组患者OS优于mGPS 1、2分组(P<0.001)。单因素Cox分析发现年龄<65岁(P=0.022)、分期为Ⅰ和Ⅱ期(P<0.001)、手术(P<0.001)、接受化学疗法(化疗)(P=0.018)和mGPS 0分(1 vs.0分,P=0.008;2 vs.0分,P<0.001)都是肺癌患者OS的保护性因素。多因素分析年龄[HR=0.680,95%CI(0.508,0.911),P=0.010]、分期[HR=0.580,95%CI(0.359,0.939),P=0.027]、手术[HR=0.254,95%CI(0.140,0.459),P<0.001]、化疗[HR=0.624,95%CI(0.435,0.893),P=0.010]、mGPS(1 vs.0分)[HR=1.548,95%CI(1.101,2.176),P=0.012]和mGPS(2 vs.0分)[HR=1.425,95%CI(1.003,2.024),P=0.048]都是影响肺癌患者OS的独立因素。结论mGPS是影响肺癌患者预后的独立性因素。

Objective To explore the prognostic value of modified Glasgow Prognostic Score(mGPS)in lung cancer patients.Methods The clinical data and follow-up information of patients with lung cancer diagnosed for the first time in West China Hospital of Sichuan University from August 2008 to May 2013 were retrospectively analyzed.Overall survival(OS)of patients with different mGPS were compared by Kaplan-Meier test and log-rank test.Univariate and multivariate Cox proportional hazard analysis were performed,and hazard ratio(HR)and 95%confidence interval(CI)were counted to evaluate the predictive value of different prognostic factors in patients with lung cancer.Results A total of 289 patients were included.According to the mGPS score,127 patients had 0 point,90 patients had 1 point,and 72 patients had 2 points.The OS of lung cancer patients with mGPS=0 was better than that of patients with mGPS=1 and mGPS=2(P<0.001).Cox proportional hazards of univariate analysis revealed that age<65(P=0.022),stage forⅠandⅡ(P<0.001),surgery(P<0.001),chemotherapy(P=0.018),and mGPS=0(1 vs.0,P=0.008;2 vs.0,P<0.001)were the protective factors for lung cancer patients(P<0.05).Multiple-factor analysis showed that age[HR=0.680,95%CI(0.508,0.911),P=0.010],stage[HR=0.580,95%CI(0.359,0.939),P=0.027],operation[HR=0.254,95%CI(0.140,0.459),P<0.001],chemotherapy[HR=0.624,95%CI(0.435,0.893),P=0.010],mGPS(1 vs.0)[HR=1.548,95%CI(1.101,2.176),P=0.012]and mGPS(2 vs.0)[HR=1.425,95%CI(1.003,2.024),P=0.048]were independent predictors of OS in patients with lung cancer.Conclusion mGPS could be considered as an independent prognostic factor in lung cancer.