胆囊癌患者术前两种炎症评分的预测效能比较

Comparison of predictive efficacy of two preoperative inflammatory scores in patients with gallbladder cancer

目的比较全身炎症系统评分(SIS)与改良型格拉斯哥评分(mGPS)对行胆囊癌根治性手术患者的预测效能。方法运用回顾性队列研究的方法收集2010年3月—2020年3月在东南大学附属中大医院行根治性手术治疗的共50例胆囊癌患者临床资料。使用COX生存分析评估SIS及mGPS对患者预后的影响。并通过时间依赖的ROC曲线和亚组分析来比较两者的预测准确性。符合正态分布的计量资料用均数±标准差(x^(-)±s)表示, 组间比较采用t检验;计数资料组间比较采用χ^(2)检验。结果共50例患者接受胆囊癌根治性手术, 其中1、2、3年总体生存率分别为76%、55%、37.6%。COX多因素分析显示, SIS(HR=2.072, P=0.014)是预后独立危险因素;时间依赖的ROC曲线分析发现在术后1年时, SIS曲线下面积大于mGPS, 差异有统计学意义(0.748比0.603, P=0.024);亚组分析发现在晚期患者中, SIS相较于mGPS有统计学意义(P=0.03)。结论 SIS在预测接受胆囊癌根治性手术患者的总体生存中优于mGPS, 且SIS是行胆囊癌根治手术患者的预后独立危险因素。

Objective To investigate and compare the influence of systemic inflammation score(SIS)and modified glasgow prognostic score(mGPS)on patients undergoing radical surgery for gallbladder cancer.Methods A cohort study was used to collect the clinical data of total 50 patients with gallbladder cancer who underwent radical surgery in Zhongda Hospital Affiliated to Southeast University from March 2010 to March 2020.Survival analysis was utilized to assess the impact of SIS and mGPS for prognosis.The predictive accuracy of each score was compared by means of subgroup analysis and time dependent receiver operating characteristics analysis.Measurement data with normal distribution were expressed as meanx±standard deviation(x^(-)±s),and t test was used for comparison between groups.Count data were expressed as cases and percentages(%),and chi-square test was used for comparison between groups.Results The 1-,2-and 3-year survival rate of 50 gallbladder cancer patients undergoing radical surgery were 76%,55%,37.6%.Cox mulivariate analysis showed SIS score(HR=2.072,P=0.014)was independent prognostic risk factor;Time dependent ROC curve analysis found that the area under the SIS curve was significantly greater than the mGPS at postoperative 1 year(0.748 us 0.603,P=0.024);Subgroup analysis found in advanced patients,SIS score was statistically significant compared with mGPS(P=0.03).Conclusions SIS is superior to mGPS for predicting OS in patients with gallbladder cancer who underwent radical surgery,and SIS is an independent risk factors for prognosis of patients with gallbladder cancer.