Charlson合并症指数对低位直肠癌根治术患者预后的预测价值

Predictive value of Charlson comorbidity index for the prognosis of low rectal cancer patients undergoing radical surgery

目的探讨Charlson合并症指数(CCI)对低位直肠癌根治术患者预后的预测价值。方法根据CCI评分的不同将84例低位直肠癌根治术患者分为轻度组(CCI评分≤3分,n=64)和严重组(CCI评分≥4分,n=20)。比较两组患者的临床特征;随访6个月,比较两组患者的生存情况。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析CCI评分对低位直肠癌根治术患者预后的预测价值。结果轻度组和严重组患者的年龄、分化程度、TNM分期比较,差异均有统计学意义(P<0.05)。轻度组患者的6个月生存率为87.50%,明显高于严重组患者的65.00%,差异有统计学意义(P<0.01)。ROC曲线显示,CCI评分对低位直肠癌根治术患者的预后具有较高的预测价值,AUC为0.817(95%CI:0.702~0.933),灵敏度为83.33%,特异度为66.67%。结论CCI评分对低位直肠癌根治术患者的预后具有较高的预测价值,CCI评分≥4分的患者生存率较低,临床应予以重点关注。

Objective To explore the predictive value of Charlson comorbidity index(CCI)for the prognosis of low rectal cancer patients undergoing radical surgery.Method A total of 84 low rectal cancer patients who received radical surgery were divided into mild group(CCI score≤3 points,n=64)and severe group(CCI score≥4 points,n=20)according to different CCI scores.The clinical characteristics of the two groups were compared.Followed up for 6 months,the survival of the two groups were compared.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the predictive value of CCI score for the prognosis of low rectal cancer patients undergoing radical surgery was analyzed.Result There were significant differences in age,differentiation degree and TNM stage between mild group and severe group(P<0.05).The 6-month survival rate in the mild group was 87.50%,which was significantly higher than 65.00%in the severe group,and the difference was statistically significant(P<0.01).ROC curve showed that CCI score had high predictive value for the prognosis of low rectal cancer patients undergoing radical surgery,the AUC was 0.817(95%CI:0.702-0.933),the sensitivity was 83.33%,and the specificity was 66.67%.Conclusion CCI score has a high predictive value for the prognosis of low rectal cancer patients undergoing radical surgery,patients with CCI score≥4 points have lower survival rate,which should be paid more attention to clinically.