全身炎症评分在不可切除转移性结直肠癌患者预后评估中的价值

Value of systemic inflammatory score in prognostic assessment of patients with unresectable metastatic colorectal cancer

目的探讨全身炎症评分(SIS)对不可切除转移性结直肠癌(mCRC)患者预后评估中的价值。方法回顾性分析2014年1月至2016年12月中南大学湘雅医学院附属海口医院收治的130例不可切除mCRC患者的临床资料。分析SIS与不可切除mCRC患者临床病理特征的关系,采用Kaplan-Meier法进行生存分析,应用Cox回归模型对影响不可切除mCRC患者预后的危险因素进行单因素及多因素分析。结果根据SIS结果将患者分为0分组(40例)、1分组(58例)和2分组(32例)。年龄、性别、原发肿瘤位置、功能状态评分、组织类型、RAS基因状态、转移器官数目、腹膜扩散、分子靶向治疗方面分层患者间不同SIS患者构成差异均无统计学意义(均P>0.05)。Kaplan-Meier生存分析结果显示,SIS 0分、1分、2分组5年总生存率分别为37.5%、19.0%、6.3%,三组差异有统计学意义(χ^(2)=3.152,P<0.01)。多因素Cox回归分析结果显示,女性、原发肿瘤位置为右侧、SIS 1-2分是不可切除mCRC患者总生存的独立危险因素(均P<0.05)。结论SIS可能为不可切除mCRC患者预后评估的重要指标,高SIS患者预后差。

Objective To investigate the prognostic value of systemic inflammatory score(SIS)in prognostic assessment of patients with unresectable metastatic colorectal cancer(mCRC).Methods The clinical data of 130 patients with unresectable mCRC in Affiliated Haikou Hospital of Xiangya Medical College of Central South University from January 2014 to December 2016 were retrospectively analyzed.The relationship between SIS and clinicopathological characteristics of unresectable mCRC patients was also analyzed.The survival analysis was made by using Kaplan-Meier.The risk factors affecting the prognosis of unresectable mCRC patients were analyzed by using Cox regression model to make univariate and multivariate analysis.Results According to SIS results,patients were divided into 0-score group(40 cases),1-score group(58 cases),and 2-score group(32 cases).There were no significant differences in different SIS constitution patients stratified by age,gender,primary tumor location,functional status score,tissue type,RAS gene status,number of metastatic organs,peritoneal spread and molecular targeted therapy(all P>0.05).Kaplan-Meier survival analysis showed that the 5-year overall survival rates of SIS 0-score,1-score and 2-score group were 37.5%,19.0%,6.3%,respectively;and the difference was statistically significant(χ^(2)=3.152,P<0.01).Cox regression survival analysis showed that female,primary tumor location in right side and SIS(scores of 1-2)were independent risk factors for overall survival in patients with unresectable mCRC(all P<0.05).Conclusion SIS may be an important indicator for prognostic assessment of patients with unresectable mCRC,and patients with high SIS have poor prognosis.