格拉斯哥预后评分对鼻咽癌放化疗患者预后判断的临床价值

The clinical value of Glasgow Prognostic Score in predicting the clinical prognosis of patients with nasopharyngeal carcinoma undergoing radiotherapy and chemotherapy

目的探讨格拉斯哥预后评分(GPS)在鼻咽癌放化疗患者临床预后预测中的价值。方法2010年1月至2016年6月于核工业四一六医院放化疗的鼻咽癌患者146例,回顾性收集患者资料,随访至2022年6月30日,采用Kaplan-Meier法绘制生存曲线,Log-rank检验和Cox回归分析鼻咽癌患者预后的影响因素。结果中位随访时间67.5个月,随访期内死亡32例(21.92%),146例患者3、5、8年生存率分别为93.84%、80.14%和78.08%。不同肿瘤分期、T分期、N分期、白蛋白、淋巴细胞数量、白细胞数量、体质量指数、C反应蛋白、NRS 2002评分及GPS的鼻咽癌患者生存时间差异有统计学意义(P<0.05),Cox回归分析发现:GPS(1分、2分)和N分期是患者预后的危险因素,LYM≥1.75×10^(9)/L则是保护因素。结论放化疗前营养、炎症和免疫状况与鼻咽癌患者临床预后有关,GPS、LYM和N分期可以作为患者预后的独立预测因子。

Objective To investigate the clinical value of Glasgow Prognostic Score(GPS)in predicting the prognosis of na-sopharyngeal carcinoma(NPC)patients undergoing radiochemotherapy.Methods From January 2010 to June 2016,146 NPC patients received radiochemotherapy in our hospital were retrospectively collected.The patients were followed up until June 30,2022.Kaplan-Meier method was used to draw the survival curve.Log-rank test and Cox regression were used to analyze the prognostic factors of the NPC patients.Results The median follow-up time was 675 months.During the follow-up period,32 patients died(21.92%).The 3-year,5-year and 8-year survival rates of the 146 patients were 93.84%,80.14%and 78.08%,respectively.There were significant difference of survival time among the 146 NPC patients with different tumor stage,T stage,N stage,albumin(ALB),lymphocyte(LYM),white blood cells(WBC),body mass index(BMI),C-reactive protein(CRP),NRS 2002 score and GPS(P<0.05).Cox regression analysis showed that GPS(1 point,2 points)and N stage were the risk factors for the prognosis of NPC patients.LYM≥175×10^(9)/L was the protective factor.Conclusions The status of nutritional,inflammatory and immune before radiochemotherapy is associated with the clinical prognosis of the NPC patients.GPS,LYM and N staging can be used as inde-pendent prognostic predictors of the NPC patients.