那不勒斯预后评分对结直肠癌患者生存的预测价值

The predictive value of Naples prognostic score for the survival of colorectal cancer patients

目的探讨那不勒斯预后评分(NPS)对结直肠癌(CRC)患者生存的预测价值。方法回顾性分析2016年5月—2019年5月我院诊治的80例CRC患者临床及实验室检查资料。根据NPS评分将患者分为高NPS组(n=37)和低NPS组(n=43)。Kaplan-Meier生存分析不同NPS评分患者生存预后的差异。单因素及多因素Cox回归分析影响CRC患者预后的危险因素。受试者工作曲线分析NPS评分、预后营养指数(PNI)及营养预后控制(COUNT)评分对CRC患者预后的预测价值。结果NPS水平与CRC患者肿瘤分期、远处转移、COUNT评分和PNI有关(P<0.05)。高NPS组死亡28例,3年生存率为24.3%(9/37);低NPS组死亡13例,3年生存率为69.8%(30/43)。高NPS组患者3年生存率明显低于低NPS组患者(χ^(2)=8.124,P<0.001)。肿瘤分期、远处转移、NPS评分、COUNT评分和PNI是影响CRC患者不良预后的独立影响因素。NPS评分、PNI及COUNT评分的曲线下面积(AUC)分别为0.892(95%CI为0.785~0.998)、0.648(95%CI为0.473~0.823)及0.851(95%CI为0.725~0.978),相比于PNI及COUNT评分,NPS评分对CRC患者死亡具有较高的诊断价值(Z=11.231、9.127,均P<0.001)。结论NPS评分升高是CRC患者不良生存预后的独立危险因素,其对CRC患者预后的预测效能高于PNI及COUNT评分,是新的CRC预后的肿瘤标志物。

Objective To study the predictive value of the Naples prognostic score(NPS)on colorectal cancer patients'survival.Methods The clinical and laboratory data of 80 patients with colorectal cancer diagnosed and treated in our hospital from May 2016 to May 2019 were retrospectively analyzed.According to the NPS score,the patients were divided into two groups with high and low expression.Kaplan-Meier survival analysis were used to analyze the difference in survival prognosis of patients with different NPS scores.Univariate and multivariate Cox regression analysis were used to analyze the risk factors affecting the prognosis of colon cancer patients.The receiver operating curve were used to analyze the predictive value of NPS score,prognostic nutritional index and nutritional prognostic control score on the prognosis of colon cancer patients.Results The NPS score in colorectal cancer was related to tumor stage,distant metastasis,COUNT score and PNI(all P<0.05).There were 28 deaths in the high NPS group,and the 3-year survival rate was 24.3%(9/37);13 cases in the low NPS group died,and the 3-year survival rate was 69.8%(30/43).The 3-year survival rate of patients in the high NPS group was significantly lower than that in the low NPS group(χ^(2)=8.124,P<0.001).Tumor staging,distant metastasis,NPS score,COUNT score and PNI were independent factors affecting the poor prognosis of colon cancer patients.The area under the curve(AUC)of NPS score,PNI and COUNT score were 0.892(95%CI 0.785~0.998),0.648(95%CI 0.473~0.823)and 0.851(95%CI 0.725~0.978),respectively.Compared with the PNI and COUNT scores,the NPS score has a higher diagnostic value for the death of colorectal cancer patients(Z=11.231,9.127,all P<0.001).Conclusion Increased NPS score in colorectal cancer is an independent risk factor for poor survival and prognosis of patients.The predictive power of NPS for the prognosis of colorectal cancer patients is higher than that of the prognostic nutritional index and nutritional prognosis control score,and maybe a new tumor marker for the prognosis of colon cancer.