Gustave Roussy Immune Score——结直肠癌患者的新型预后评分

Gustave Roussy Immune Score:A novel prognostic score for colorectal cancer patients

目的探讨Gustave Roussy Immune Score(GRIm评分)在结直肠癌(CRC)根治术后患者预后评估中的价值。方法本研究共纳入2004年6月至2019年8月271例CRC根治术后患者。分析GRIm评分与CRC临床病理特征的关系。采用Kaplan-Meier法绘制CRC患者无病生存时间(DFS)曲线,生存差异行Log-rank检验;Cox风险比例回归模型分析影响CRC患者预后的因素;校准曲线和受试者工作特征(ROC)曲线检验基于GRIm评分的列线图的预测效能。结果GRIm评分与性别、肿瘤部位、神经侵犯、N分期、美国癌症联合委员会(AJCC)分期、白蛋白(ALB)评分和乳酸脱氢酶(LDH)评分有关(P<0.05);GRIm简化评分与肿瘤部位、肿瘤直径、癌栓、ALB评分和LDH评分有关(P<0.05)。Cox风险比例回归模型显示,GRIm评分是影响CRC患者DFS的独立因素(HR=2.546,95%CI:1.644~3.943,P<0.05)。包括GRIm评分的列线图对CRC患者DFS的预测能力优于第8版AJCC分期系统。结论GRIm评分是影响CRC患者DFS的独立因素,基于GRIm评分的列线图可以帮助临床医师有效评估CRC患者的预后,制定个体化治疗方案。

Objective To evaluate the value of Gustave Roussy Immune Score(GRIm score)in prognosis assessment of patients with colorectal cancer(CRC)after radical surgery.Methods Two hundred and seventy-one patients with CRC from June 2004 to August 2019 after radical operation were included in this study.The relationship between GRIm score and clinicopathological features of CRC was analyzed.Disease-free survival(DFS)curves of CRC patients were plotted by Kaplan-Meier method,and survival differences were tested by Log-rank test.Cox proportional regression model was used to analyze the prognostic factors of CRC patients.Calibration curve and receiver operating characteristic(ROC)curve examined the predictive power of GRIm score based nomogram.Results GRIm score was correlated with sex,tumor site,nerve invasion,N stage,American Joint Committe on Carcer(AJCC)stage,albumin(ALB)score and lactate dehydrogenase(LDH)score(P<0.05).GRIm simplified score was related to tumor site,tumor diameter,cancer thrombus,ALB score and LDH score(P<0.05).Cox proportional regression model showed that GRIm score was an independent factor affecting DFS of CRC patients(HR=2.546,95%CI:1.644-3.943,P<0.05).The nomogram containing the GRIm score predicted DFS better than the eighth edition of AJCC staging system.Conclusion GRIm score is an independent factor affecting the DFS of CRC patients.The GRIm score based nomogram can help clinicians effectively evaluate the prognosis of CRC patients and formulate individualized treatment plan.