改良mGPS评分对甲状腺乳头状癌患者手术预后的预测效果

Analysis of the predictive effect of improved mGPS score on surgical prognosis of patients with papillary thyroid carcinoma

目的 探讨改良基线格拉斯哥评分(mGPS评分)对甲状腺乳头状癌(PTC)患者手术预后的预测效果。方法 选取2017年6月~2019年6月四川大学华西医院收治的126例PTC患者为研究对象。按照患者术前mGPS评分,将其分别纳入0分组(n=78)、1分组(n=35)、2分组(n=13)。比较3组3年无进展生存情况,并比较不同预后患者基线临床资料。运用Logistic多因素回归分析,总结影响患者预后的因素,并使用受试者工作特征曲线(ROC)验证改良mGPS评分预测患者预后的效能。结果 mGPS评分0分者3年无进展生存率为94.87%(74/78),高于1分者的68.57%(24/35),高于2分者的46.15%(6/13),差异有统计学意义(P<0.05)。126例患者中,共有22例患者预后不良,预后不良率为17.46%。Logistic多因素回归分析示,年龄≥50岁、病灶直径≥0.65 cm、临床分期Ⅲ~Ⅳ期、病灶多发、改良mGPS评分≥1分均为影响PTC患者手术预后的独立危险因素(P<0.05)。ROC曲线示,mGPS评分≥1分预测PTC患者预后不良的灵敏度、特异性分别为86.36%、97.12%,AUC为0.952(P<0.05)。结论 随着改良mGPS评分的升高,PTC患者术后无进展生存期有缩短趋势,且改良mGPS评分≥1分能够较为准确地预测患者不良预后的发生。

Objective To analyze the predictive effect of modified baseline Glasgow score(mGPS score) on the surgical prognosis of patients with papillary thyroid carcinoma(PTC).Methods The clinical data of 126 PTC patients in West China Hospital,Sichuan University from June 2017 to June 2019 were collected.According to the preoperative mGPS score,the patients were divided into 0,1 and 2 groups,respectively.The 3-year progression-free survival of the three groups was compared,and the baseline clinical data of patients with different prognosis were compared.Logistic multiple regression analysis was used to summarize the factors influencing the prognosis of patients,and receiver operating characteristic curve(ROC) was used to verify the efficacy of improved mGPS score in predicting the prognosis of patients.Results Among the 126 patients,78 cases scored 0,35 cases scored 1 and 13 cases scored 2.The 3-year progression-free survival rate of patients with mGPS score of 0 was 94.87%(74/78),which was higher than that of patients with MGPS score of 1(68.57%,24/35) and score of 2(46.15%,6/13),with statistical significance(P<0.05).Among the 26 patients,22 patients had poor prognosis,and the poor prognosis rate was 17.46%.Logistic regression analysis showed that age ≥50 years old,lesion diameter ≥0.65 cm,clinical stage Ⅲ~Ⅳ,multiple lesions and mGPS score ≥1 were independent risk factors for the prognosis of PTC patients(P<0.05).ROC curve showed that the sensitivity and specificity of mGPS score ≥1 in predicting the poor prognosis of PTC patients were 86.36%,97.12%,and AUC was 0.952(P<0.05).Conclusion With the increase of modified mGPS score,the progression-free survival of PTC patients tends to shorten,and the modified mGPS score ≥1 can accurately predict the occurrence of adverse prognosis.