Naples Prognostic Score Is a Useful Prognostic Marker in Patients With Metastatic Colorectal Cancer
Naples Prognostic Score Is a Useful Prognostic Marker in Patients With Metastatic Colorectal Cancer
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DOI：
10.1097/dcr.0000000000001484
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发表时间：
2019-12-01
影响因子：
3.9
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
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作者：
Miyamoto, Yuji;Hiyoshi, Yukiharu;Baba, Hideo
背景：全身炎症可能影响各种癌症患者对全身化疗的反应或预后。基于炎症和营养状态的那不勒斯预后评分对于接受结直肠癌手术的患者来说是一个有用的预后标记。然而，其对转移性结直肠癌患者的意义仍不清楚。目的：评估那不勒斯预后因素对接受一线化疗的转移性结直肠癌患者的预后意义，并与中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值以及全身免疫炎症指标比较其预后准确性。设计：这是对前瞻性收集的数据进行的回顾性研究。背景：这项研究是在一所大学医院进行的。患者：共有 259 名患者接受了转移性结直肠癌的一线全身化疗。主要观察指标：那不勒斯预后评分通过白蛋白和胆固醇浓度、淋巴细胞与单核细胞比率以及中性粒细胞与淋巴细胞比率的综合评分来计算。根据Naples评分的增加将患者分为3组（0-2组），并评估Naples预后评分与临床病理特征和总生存率的关联。结果：较高的那不勒斯预后评分与右侧原发肿瘤和同步转移呈正相关，与原发肿瘤切除呈负相关。第 2 组（高那不勒斯预后评分）患者的总生存期显着短于第 0 组和第 1 组患者（p = 0.012 和 0.022）。多变量 Cox 回归分析将那不勒斯预后评分确定为总生存期的独立预后因素（HR = 1.574；p = 0.004）。时间依赖性受试者工作特征曲线分析表明，那不勒斯预后评分对于预测总生存期比其他预后因素更敏感。局限性：主要局限性是样本量、单一机构特征和治疗异质性。结论：那不勒斯预后评分可能是接受全身化疗的转移性结直肠癌患者的有用预后标志物。请参阅视频摘要：http://links.lww.com/DCR/B72。
BACKGROUND: Systemic inflammation may influence the response to systemic chemotherapy or the prognosis in patients with various cancers. The Naples prognostic score, based on inflammatory and nutritional statuses, is a useful prognostic marker in patients undergoing surgery for colorectal cancer; however, its significance in patients with metastatic colorectal cancer remains unclear. OBJECTIVE: We aimed to evaluate the prognostic significance of the Naples prognostic factor in patients with metastatic colorectal cancer receiving first-line chemotherapy and to compare its prognostic accuracy with the neutrophil:lymphocyte ratio, platelet:lymphocyte ratio, and the systemic immune-inflammatory index. DESIGN: This was a retrospective study of prospectively collected data. SETTINGS: This study was conducted at a university hospital. PATIENTS: A total of 259 patients received first-line systemic chemotherapy for metastatic colorectal cancer. MAIN OUTCOME MEASURES: The Naples prognostic score was calculated by a composite score of albumin and cholesterol concentrations, lymphocyte:monocyte ratio, and neutrophil:lymphocyte ratio. The patients were divided into 3 groups based on increasing Naples scores (groups 0-2), and the associations of the Naples prognostic score with clinicopathologic features and overall survival were evaluated. RESULTS: Higher Naples prognostic score was positively associated with right-sided primary tumors and synchronous metastases and negatively with primary tumor resection. Patients in group 2 (high Naples prognostic score) had significantly shorter overall survival than those in groups 0 and 1 (p = 0.012 and 0.022). Multivariate Cox regression analysis identified the Naples prognostic score as an independent prognostic factor for overall survival (HR = 1.574; p = 0.004). Time-dependent receiver operating characteristic curve analysis showed that Naples prognostic score was more sensitive than other prognostic factors for predicting overall survival. LIMITATIONS: The main limitations are the sample size, single institutional feature, and treatment heterogeneity. CONCLUSIONS: The Naples prognostic score may be a useful prognostic marker in patients with metastatic colorectal cancer receiving systemic chemotherapy. See Video Abstract at http://links.lww.com/DCR/B72.