术前Glasgow预后分数对判断直肠癌预后的价值
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杜晓辉,Email: duxiaohui301@sina.com

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国家自然科学基金资助项目(60601018;61170123)。


Prognostic value of preoperative Glasgow prognostic score for rectal cancer
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    摘要:

    目的:探讨术前格拉斯哥预后分数(GPS)对直肠癌手术预后的判断价值。方法:回顾6年半内经手术治疗的219例直肠癌患者的临床资料,分析影响直肠癌患者预后的相关因素,并以术前GPS分值将患者分为GPS 2分组,GPS 1分组和GPS 0分组,分析术前GPS与患者临床病理特征的关系,以及比较3组患者的生存情况。结果:单因素分析显示术前癌胚抗原(CEA),C反应蛋白(CRP),清蛋白水平,TNM分期,GPS与患者总生存时间有关(均P<0.05);GPS与术前CEA,CA19-9,CA724,CRP,清蛋白水平,Dukes,TNM分期有关(均P<0.05)。单因素Logistic回归分析发现,术前CEA,CA19-9,CA724,CRP,清蛋白水平,肿瘤分化程度,Dukes及TNM分期和GPS与术后死亡有关(均P<0.05),进一步多因素Logistic回归分析提示,术前清蛋白浓度,分化程度,TNM分期和GPS是术后死亡的独立危险因素(均P<0.05)。GPS 2分组,GPS 1分组与GPS 0分组术后5年生存率分别为13.8%,59.9%,88.4%,3组间差异有统计学意义(P<0.001)。结论:术前GPS可作为评估直肠癌术后预后的有效指标。

    Abstract:

    Objective: To determine the prognostic predictive value of preoperative Glasgow prognostic score (GPS) in rectal cancer patients after surgery. Methods: The clinical data of 219 patients with rectal cancer undergoing surgical treatment over the past six and a half years were reviewed. The related factors that affect prognosis were analyzed, and the patients were divided into score-2 group, score-1 group and score-0 group according to their preoperatvie GPS, to analyze the relations of GPS with the clinical features of the patients, and to compare the postoperative survivals among the 3 groups. Results: Univarate analysis showed that the preoperative levels of carcinoembryonic antigen (CEA), C reactive protein (CRP), and albumin, TNM classification and GPS were associated with the overall survival of the patients (all P<0.05); GPS of the patients was relevant to their preoperative levels of CEA, CA19-9, CA724, CRP, and albumin, Dukes’ stage and TNM classification (all P<0.05). Univariate Logistic regression analysis suggested that the preoperative levels of CEA, CA19-9, CA724, CRP, and albumin, differentiation degree of the tumor, Dukes’ stage and TNM classification and GPS were associated with the increased risk of postoperative death (all P<0.05), and further multivariate Logistic regression analysis identified that preoperative albumin level, differentiation degree, TNM classification and GPS were independent risk factors for postoperative death (all P<0.05). The 5-year survival rate of score-2, score-1 and score-0 group was 13.8%, 59.9% and 88.4% respectively, and the difference among them had statistical significance (P<0.001). Conclusion: Preoperative GPS can be used as a prognostic predictor for postoperative survival of rectal cancer patients.

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肖春红|刘海亮|薛虎臣|宁宁|李松岩|杜晓辉.术前Glasgow预后分数对判断直肠癌预后的价值[J].中国普通外科杂志,2013,22(4):423-428.
DOI:10.7659/j. issn.1005-6947.2013.04.008

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  • 收稿日期:2012-11-06
  • 最后修改日期:2013-02-28
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  • 在线发布日期: 2013-04-12