NPS与局部晚期直肠癌新辅助放化疗疗效及预后相关性初步分析  

Correlation analysis between Naples prognostic score and treatment outcomes for locally advanced rectal cancer

作　　者：朱佳浩 高其忠[2] 郭信伟 刘政操[4] 杨波[1] 冀胜军[4] 赵于天 Zhu Jiahao;Gao Qizhong;Guo Xinwei;Liu Zhengcao;Yang Bo;Ji Shengjun;Zhao Yutian(Department of Radiotherapy and Oncology,Affiliated Hospital of Jiangnan University,Wuxi 214000,China;Department of Gastrointestinal Surgery,Affiliated Hospital of Jiangnan University,Wuxi 214000,China;Department of Radiotherapy and Oncology,Affiliated Taixing People′s Hospital of Yangzhou University,Taixing 225400,China;Department of Radiotherapy and Oncology,Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215000,China)

机构地区：[1]江南大学附属医院肿瘤放疗科,无锡214000 [2]江南大学附属医院胃肠外科,无锡214000 [3]扬州大学附属泰兴人民医院肿瘤放疗科,225400 [4]南京医科大学附属苏州医院放疗科,215000

出　　处：《中华放射肿瘤学杂志》2021年第12期1256-1261,共6页Chinese Journal of Radiation Oncology

基　　金：苏州市肿瘤临床医学中心项目(Szzx201506);无锡市"科教强卫"工程资金项目(FZXK004)。

摘　　要：目的分析Naples预后评分(NPS)与局部晚期直肠癌(LARC)新辅助治疗疗效相关性及其预测预后价值。方法回顾性分析2015—2020年136例LARC患者资料,搜集并计算新辅助治疗前血清白蛋白、总胆固醇、中性粒细胞与淋巴细胞比值和淋巴细胞与单核细胞比值,根据NPS法则对入组患者进行评分分级。采用Kaplan-Meier法计算生存率,Cox模型多因素预后分析。结果NPS与LARC新辅助治疗后肿瘤退缩程度及术后pCR无相关性(P=0.192、0.163)。Cox多因素分析显示NPS是LARC的总生存(OS)及无瘤生存(DFS)的独立危险因素(P=0.017、0.003),且分层分析提示评分越低者预后较好;此外,肿瘤大小也是OS的独立危险因素,肿瘤大小与N分期也是DFS的独立危险因素。结论NPS与LARC新辅助放化疗后肿瘤退缩及pCR无相关性,但能作为LARC治疗长期预后的有效预测指标。Objective To analyze the correlation between the Naples prognostic score(NPS)after preoperative neoadjuvant chemoradiotherapy in locally advanced rectal cancer(LARC)and evaluate the prognostic value of NPS in LARC.Methods 136 patients with LARC meeting the recruitment criteria from 2015 to 2020 were selected.Serum albumin,total cholesterol(TC)were collected and neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio were calculated.All patients were scored and graded according to the NPS rule.The survival rate was calculated with Kaplan-Meier method.Multivariate prognostic analysis was performed by Cox models.Results There was no significant correlation between NPS score and tumor regression or pathological complete response(pCR)of LARC patients after neoadjuvant therapy(P=0.192,P=0.163).However,Cox multivariate analysis showed that NPS was an independent risk factor for overall survival(OS)and disease-free survival(DFS)of LARC(P=0.009,P=0.003),and hierarchical analysis suggested that LARC patients with lower NPS score obtained better prognosis.Besides NPS,tumor size was also an independent risk factor for OS,and tumor size and N stage were the independent risk factors for DFS.Conclusion NPS has no correlation with tumor regression or pCR for LARC after neoadjuvant chemoradiotherapy,whereas it could serve as an effective predictor for long-term prognosis of LARC.

关 键 词：直肠肿瘤 局部晚期/新辅助放化疗法 Naples预后评分 预后 

分 类 号：R735.37[医药卫生—肿瘤]