高敏感格拉斯哥评分对进展期胃癌患者新辅助化疗疗效和预后的预测作用  

Predictive and Prognostic significance of high-sensitivity modified Glasgow Prognostic Score （HS- mGPS） in advanced gastric cancer patients treated with neoadjuvant chemotherapy

作　　者：崔瑶[1] 李剑[2] 曹养辉[2] 刘明月[1] 史祖宣[1] 高天慧[1] Cui Yao Li Jian Cao Yanghui Liu Mingyue Shi Zuxuan Gao Tianhui(Department of Oncology, Henan Provincial People＇ s Hospital （Zhengzhou University People＇ s Hospital ） , Zhengzhou, Henan 450003, China Department of General Surgery, Henan Cancer Hospital, Zhengzhou University, Zhengzhou, Henan 450008, China)

机构地区：[1]河南省人民医院郑州大学人民医院肿瘤科,450003 [2]河南省肿瘤医院胃肠外科,郑州450008

出　　处：《中华肿瘤杂志》2017年第3期195-200,共6页Chinese Journal of Oncology

基　　金：河南省科技攻关项目（162102310041）

摘　　要：目的探讨高敏感格拉斯哥评分（HS－mGPS）对进展期胃癌患者新辅助化疗疗效和预后的预测作用。方法117例进展期胃癌患者术前接受SOX方案（奥沙利铂＋替吉奥）或mFOLFOX6方案（奥沙利铂＋亚叶酸钙＋氟尿嘧啶）新辅助化疗，根据C反应蛋白（CRP）和血清白蛋白（ALB）水平计算HS－mGPS，分析HS－mGPS与进展期胃癌患者临床病理特征的关系以及影响新辅助化疗胃癌患者预后的因素。结果117例接受新辅助化疗的进展期胃癌患者中，ⅡB期43例，Ⅲ期60例，Ⅳ期14例。新辅助化疗后的临床有效率为61.5%（72/117），疾病控制率为88.0%（103/117），组织学反应率为91.5%（107/117），R0切除率为81.2%（95/117）。全组患者的中位无病生存时间（DFS）为21.0个月（95%CI为6.4-35.6个月），中位总生存时间（OS）为39.0个月（95%CI为21.4-56.6个月）。HS－mGPS与进展期胃癌患者的T分期、N分期、M分期、化疗疗效和组织学反应有关（均P〈0.05）。单因素和多因素分析显示，HS－mGPS、N分期和R0切除是影响进展期胃癌患者中位DFS和OS的独立因素（均P〈0.05）。结论HS－mGPS可用于预测胃癌新辅助化疗的疗效和预后。Objective To study the predictive and prognostic significance of high-sensitivity modified Glasgow Prognostic Score （HS-mGPS） on the effect of neoadjuvant chemotherapy for advanced gastric cancer. Methods 117 patients with advanced gastric cancer received neoadjuvant chemotherapy with SOX （oxaliplatin＋Sl） or mFOLFOX 6（oxaliplatin＋CF＋5-FU） regimen. HS-mGPS was calculated according to blood C-reactive protein （CRP） concentration and serum albumin （ALB） level. The correlation between HS-mGPS and clinicopathological characteristics was determined and the predictors of survival were analyzed. Results 117 patients with stage [[ B （43 cases）, stage m 〈 60）, and stage IV （14） received preoperative neoadjuvant chemotherapy. The overall response rate of neoadjuvant chemotherapy was 61.5% （72/117）, and the tumor control rate was 88.0% （103/117） , with a pathological response rate of 91.5% （107/117）. The R0 resection rate was 81.2% （95/117）. The median disease-free survival （DFS） was 21.0 （ 95% CI 6.4-35.6） months. The median overall survival （OS） was 39.0 （95% CI 21.4-56.6） months. Higher HS- mGPS was associated with higher T stage, local lymph-node metastasis, distant metastasis, lower chemotherapy overall response rate and lower pathological response rate （all P 〈 0. 05 ）. The univariate analysis and multivariate analysis showed that higher HS-mGPS, presence of local lymph-node metastasis and non R0 resection were associated with poorer DFS and OS （P〈0.05）. Conclusion HS-mGPS can be used to predict the benefits of neoadjuvant chemotherapy and as an independent prognostic factor for survival in patients with advanced gastric cancer.

关 键 词：胃肿瘤 高敏感格拉斯哥评分 新辅助化疗 治疗结果 预后 

分 类 号：R735.2[医药卫生—肿瘤]