Evaluation of an inflammation-based prognostic score in patients with inoperable pancreatic cancer
Evaluation of an inflammation-based prognostic score in patients with inoperable pancreatic cancer
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DOI：
10.1159/000094562
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发表时间：
2006-01-01
期刊：
影响因子：
3.6
通讯作者：
McKay, Colin J.
中科院分区：
文献类型：
--
作者：
Glen, Paul;Jamieson, Nigel B.;McKay, Colin J.
背景/目的：胰腺癌患者是存活率最低的患者之一，选择患者进行积极治疗仍然是个问题。本研究评估了基于炎症的评分(格拉斯哥预后评分，GPS)在不能手术的胰腺癌患者中的价值。方法：将C反应蛋白升高(>；10 mg/L)和低蛋白血症(<；35 g/L)的患者分为2分。仅有1项或无1项生化异常的患者分为1分和0分。结果：共研究了187例患者，其中49例(26%)接受了手术姑息搭桥术。随访结束时，181例(97%)患者死亡，17%的患者在12个月时存活。在单因素分析中，年龄(p<；0.01)、TNM分期(p<；0.001)和总体评分(p<；0.001)是显著的生存预测因素。在多因素生存分析中，年龄(危险比1.53，95%可信区间1.12-2.10，p=0.008)、临床分期(危险比1.70，95%可信区间1.33-2.18，p<；0.001)和年龄(危险比1.72，95%可信区间1.40-2.11，p<；0.001)仍然是影响患者生存的独立预测因素。结论：在诊断时，全身炎症反应的存在(通过GPS测量)似乎是不能手术的胰腺癌患者预后不良的有用指标，与TNM分期无关。版权所有(C)2006 S.Karger AG，巴塞尔和IAP。
Background/Aims: Patients with pancreatic cancer have one of the poorest survival rates and selection of patients for active treatment remains problematical. The present study assesses the value of an inflammation-based score ( Glasgow Prognostic Score, GPS) in patients with inoperable pancreatic cancer. Methods: The GPS was constructed as follows: patients with both an elevated C-reactive protein (> 10 mg/l) and hypoalbuminaemia (< 35 g/l) were allocated a score of 2. Patients in whom only 1 or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively. Results: One hundred and eighty-seven patients were studied and 49 (26%) underwent an operative palliative bypass procedure. At the end of follow-up, 181 (97%) patients died, 17% of patients were alive at 12 months. On univariate analysis, age ( p < 0.01), TNM stage ( p < 0.001) and the GPS ( p < 0.001) were significant predictors of survival. On multivariate survival analysis, stratified for bypass procedure, age ( hazard ratio 1.53, 95% CI 1.12 - 2.10, p = 0.008), TNM stage ( hazard ratio 1.70, 95% CI 1.33 - 2.18, p < 0.001) and the GPS ( hazard ratio 1.72, 95% CI 1.40 - 2.11, p < 0.001) remained independent significant predictors of survival. Conclusion: At diagnosis, the presence of a systemic inflammatory response ( as measured by the GPS) appears to be a useful indicator of poor outcome, independent of TNM stage, in patients with inoperable pancreatic cancer. Copyright (C) 2006 S. Karger AG, Basel and IAP.