Naples预后评分在肝内胆管癌患者长期生存中的预测价值  

Predictive value of Naples prognostic score on long-term outcome in patients with intrahepatic cholangiocarcinoma

作　　者：姜沆 陈星 吴嘉[2,3] 韩方 胡超 徐林伟[2,3] 柳蒋书[3,4] 张宇华 Jiang Hang;Chen Xing;Wu Jia;Han Fang;Hu Chao;Xu Linwei;Liu Jiangshu;Zhang Yuhua(The Second School of Clinical Medicine,Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Hepato-Pancreato-Biliary,Zhejiang Cancer Hospital,Hangzhou 310022,China;Department of Pathology,Zhejiang Cancer Hospital,Hangzhou 310018;Hangzhou Institute of Medicine(HIM),Chinese Academy of Sciences,Hangzhou 310022,China)

机构地区：[1]浙江中医药大学第二临床医学院,杭州310053 [2]浙江省肿瘤医院肝胆胰外科,杭州310022 [3]中国科学院杭州医学研究所,杭州310018 [4]浙江省肿瘤医院病理科,杭州310022

出　　处：《中华普通外科杂志》2024年第8期609-614,共6页Chinese Journal of General Surgery

基　　金：浙江省自然科学基金(LQ23H160010);浙江省肿瘤医院国自然培育基金(PY2022024)。

摘　　要：目的探讨Naples预后评分(Naples prognostic score,NPS)对肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)患者肝切除术后总生存期(overall survival,OS)的预测价值。方法回顾性分析2010年1月至2022年8月在浙江省肿瘤医院接受肝切除治疗的164例ICC患者临床病理资料及预后数据。基于术前血清白蛋白、总胆固醇、中性粒细胞/淋巴细胞比值以及淋巴细胞/单核细胞比值计算NPS,分析NPS与OS的关系,比较NPS与TNM分期及其他独立危险因素预测长期生存的效能。结果多因素分析结果显示,NPS[1分比0分:1.864(1.011~3.437),P=0.046;2分比0分:3.013(1.465~6.199),P=0.003]是OS的独立危险因素。NPS预测ICC术后5年OS受试者工作特征曲线的曲线下面积为0.75,高于TNM分期(0.59)及其他独立危险因素(CA19-9:0.71;淋巴结转移:0.66;肿瘤大小:0.62;微血管侵犯:0.56)。结论NPS是影响ICC患者术后OS的独立危险因素。ObjectiveTo investigate the predictive value of Naples prognostic score(NPS)in assessing the overall survival of intrahepatic cholangiocarcinoma(ICC)patients after receiving hepatectomy treatment.MethodsClinicopathological characteristics and follow-up data of 164 ICC patients who underwent curative hepatectomy at Zhejiang Cancer Hospital from Jan 2010 to Aug 2022 were retrospectively collected.NPS was calculated basing on preoperative serum albumin concentration,total cholesterol concentration,the neutrophil-lymphocyte ratio,and lymphocyte-monocyte ratio.The relationship between NPS and overall survival was analyzed,and the efficacy of NPS in predicting long-term survival was compared to TNM staging system and other independent risk factors.ResultsMultivariate analysis identified the NPS[Score 1 versus 0:1.864(1.011-3.437),P=0.046;Score 2 versus 0:3.013(1.465-6.199),P=0.003]as an independent risk factor for overall survival.The area under curve(AUC)of the rece中iver operating characteristic(ROC)curve for predicting 5-year OS based on NPS is 0.75,which is higher than TNM staging(0.59)and other independent risk factors(CA19-9:0.71,lymph node metastasis:0.66,tumor size:0.62,microvascular invasion:0.56).ConclusionNPS as an independent predictor of overall survival for ICC patients,is more accurate than TNM staging system and other clinicopathological factors.

关 键 词：胆管上皮癌 存活率 Naples预后评分 曲线下面积 

分 类 号：R735.7[医药卫生—肿瘤]