控制营养状况评分对雄激素剥夺治疗前列腺癌患者预后的预测价值

Predictive value of controlling nutritional status score on the prognosis of patients with prostate cancer after androgen deprivation therapy

目的探讨控制营养状况(CONUT)评分对雄激素剥夺治疗前列腺癌患者预后的预测价值,为临床预测治疗效果提供参考依据。方法回顾性分析2018年2月至2020年3月南通市肿瘤医院收治的雄激素剥夺治疗的98例前列腺癌患者的临床资料,均完成2年随访,根据患者CONUT评分分为CONUT评分≥3分组(53例)和CONUT评分<3分组(45例)。分析两组患者一般资料的差异,不同CONUT评分前列腺癌患者生存率,影响前列腺癌患者雄激素剥夺治疗预后的单因素,并对其中差异有统计学意义的因素进行多变量Cox回归分析,筛选出影响前列腺癌患者雄激素剥夺治疗预后的独立危险因素。结果CONUT评分≥3分组TNM分期Ⅲ~Ⅳ期、前列腺癌格利森评分系统(Gleason)评分>7分、淋巴结转移、肿瘤切缘阳性的患者占比均显著高于CONUT评分<3分组;前列腺癌患者雄激素剥夺治疗后随访2年生存情况,共有66例(67.35%)患者存活,其中CONUT评分≥3分组生存率为54.72%(29/53),CONUT评分<3分组生存率为82.22%(37/45),CONUT评分<3分组患者2年生存率显著高于CONUT评分≥3分组(均P<0.05);TNM分期、Gleason评分、淋巴结转移、CONUT评分、肿瘤切缘阳性均为前列腺癌雄激素剥夺治疗患者预后的危险因素(HR值=2.237、2.309、2.125、2.784、1.958,均P<0.05);多变量Cox回归分析显示,TNM分期Ⅲ~Ⅳ期、CONUT评分≥3分、Gleason评分>7分均是前列腺癌患者雄激素剥夺治疗预后的独立危险因素(HR值=1.917、3.370、2.020,均P<0.05)。结论CONUT评分与前列腺癌患者预后密切相关,对于预测前列腺癌患者雄激素剥夺治疗预后具有重要的指导价值,CONUT评分≥3分提示患者有预后不良风险。

Objective To explore controlling nutritional status(CONUT)score on the predictive value for prognosis of patients with prostate cancer after androgen deprivation therapy,and provide reference for the clinical prediction of treatment effect.Methods The clinical data of 98 patients with prostate cancer who treated with androgen deprivation in Nantong Tumor Hospital from February 2018 to March 2020 were retrospectively analyzed,they were all followed-up for 2 years,and were divided into the CONUT score≥3 group(53 cases)and the CONUT score<3 group(45 cases)according to the patients'CONUT score.The differences of general data between the two groups,the survival rates of patients with prostate cancer with different CONUT scores,the single factors affecting the prognosis of patients with prostate cancer after androgen deprivation therapy were analyzed,and the multivariate Cox regression analysis for the factors with statistically significant differences was conducted to screen out the independent risk factors affecting the prognosis of patients with prostate cancer after androgen deprivation therapy.Results The proportion of patients with TNM stage Ⅲ~Ⅳ,Gleason score>7,lymph node metastasis and positive tumor resection margin in the CONUT score≥3 group were significantly higher than those in the CONUT score<3 group;after 2 years of follow-up,66 patients(67.35%)survived,the survival rate was 54.72%(29/53)in the CONUT score≥3 group,and the survival rate was 82.22%(37/45)in the CONUT score<3 group,the 2-year survival rate of patients in CONUT score<3 group was significantly higher than that in CONUT score≥3 group(all P<0.05);TNM stage,Gleason score,lymph node metastasis,CONUT score and positive tumor resection margin were risk factors for the prognosis of patients with prostate cancer after androgen deprivation therapy(HR=2.237,2.309,2.125,2.784,1.958,all P<0.05);multivariate Cox regression analysis showed that TNM stage Ⅲ~Ⅳ,CONUT score≥3,Gleason score>7 were independent risk factors for the prognosis of patients with prostate cancer after androgen deprivation therapy(HR=1.917,3.370,2.020,all P<0.05).Conclusion CONUT score is closely related to the prognosis of patients with prostate cancer after androgen deprivation therapy,and which has important guiding value for predicting the prognosis of patients with prostate cancer after androgen deprivation therapy.the CONUT score≥3 indicates that patients have a risk of poor prognosis.