改良格拉斯哥预后评分及相关炎性指标与骨肉瘤患者临床预后的关系  

Correlation of modified Glasgow prognostic score and inflammation-related indexes and clinical prognosis of patients with osteosarcoma

作　　者：张院[1] 彭国霖 王雅玲 蒋欣廷[1] 李娟 刘峰[3] ZHANG Yuan;PENG Guolin;WANG Yaling;JIANG Xinting;LI Juan;LIU Feng(Department of Orthopedics,the First Peoples'Hospital of Yibin,Sichuan Yibin 644000,China;Department of Orthopedics,the Second People's Hospital of Yibin,Sichuan Yibin 644000,China;School of Clinical Medicine,Chongqing Medical and Pharmaceutical College,Chongqing 401331,China)

机构地区：[1]宜宾市第一人民医院骨科,四川宜宾644000 [2]宜宾市第二人民医院骨科,四川宜宾644000 [3]重庆医药高等专科学校临床医学院,重庆401331

出　　处：《现代肿瘤医学》2023年第22期4216-4220,共5页Journal of Modern Oncology

基　　金：四川省卫生和计划生育委员会科研课题(编号:18PJ572)。

摘　　要：目的:探讨改良格拉斯哥预后评分(mGPS)、血小板/淋巴细胞比值(PLR)和淋巴细胞/单核细胞比值(LMR)对骨肉瘤患者预后预测的价值。方法:收集2000年至2018年宜宾市2所综合医院收治的骨肉瘤患者的病历资料,随访患者临床结局,采用ROC曲线分析相关指标预测患者预后的曲线下面积和最佳截断值,Kaplan-Meier法绘制生存曲线,Log-rank检验和Cox回归分析患者预后的影响因素。结果:92例患者平均生存时间50个月,随访期内发生死亡47例(51.09%)。PLR和LMR的ROC曲线下面积分别为0.731和0.630,最佳截断值为137和3.516(P<0.05)。Cox回归分析显示:诊断时有无转移和mGPS评分是患者预后的影响因素,诊断时有转移、mGPS=1分和2分的HR(95%CI)分别为3.669(1.743~7.721)、10.860(4.072~28.965)和26.240(8.977~76.700)(P<0.05)。诊断时有转移和无转移的患者5年生存率分别为10.26%和79.25%,mGPS评分为0、1和2分的患者5年生存率分别为87.76%、7.41%和6.25%。结论:骨肉瘤患者预后与mGPS评分和诊断时有无转移有关。Objective:To explore the value of modified Glasgow prognostic score(mGPS),platelet to lymphocyte ratio(PLR)and lymphocyte to monocyte ratio(LMR)in predicting clinical prognosis among patients with osteosarcoma.Methods:The medical records of patients with osteosarcoma in two hospitals in Yibin from 2000 to 2018 were collected,and the clinical outcomes of patients were followed up.The area under the curve(AUC)and the best cut-off value of relevant indicators were analyzed by receiver operating characteristic(ROC)curve to predict the prognosis of patients.Kaplan-Meier method was used to draw survival curve.Log-rank test and Cox regression were used to analyze the influencing factors of prognosis among patients.Results:The average survival time of 92 patients was 50 months,and 47 cases(51.09%)died during the follow-up period.The AUC of PLR and LMR was 0.731 and 0.630,respectively,and the best cut-off values were 137 and 3.516(P<0.05).Cox regression showed that presence or absence of metastasis when diagnosis and mGPS score were influencing factors for patient prognosis.The HR(95%CI)for the presence of metastasis when diagnosis,mGPS=1 score,and mGPS=2 scores was 3.669(1.743~7.721),10.860(4.072~28.965),and 26.240(8.977~76.700)(P<0.05),respectively.The 5-year survival rates of patients with and without metastasis when diagnosis were 10.26%and 79.25%,respectively.The 5-year survival rates of patients with mGPS scores of 0,1,and 2 were 87.76%,7.41%,and 6.25%,respectively.Conclusion:The prognosis of osteosarcoma patients is related to the mGPS score and whether metastasis when diagnosis.

关 键 词：骨肉瘤 改良格拉斯哥预后评分(mGPS) 血小板/淋巴细胞比值(PLR) 淋巴细胞/单核细胞比值(LMR) KAPLAN-MEIER法 预后 

分 类 号：R738.1[医药卫生—肿瘤]