Significant host- and tumor-related factors for predicting prognosis in patients with esophageal carcinoma
Significant host- and tumor-related factors for predicting prognosis in patients with esophageal carcinoma
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DOI：
10.1097/01.sla.0000080822.22415.cb
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发表时间：
2003-08-01
影响因子：
9
通讯作者：
Aikou, T
中科院分区：
文献类型：
--
作者：
Ikeda, M;Natsugoe, S;Aikou, T
目的：确定食道癌患者治疗前可获得的预测临床预后的有用参数。摘要背景资料：关于肿瘤的生物学状态或患者的营养状态的各种因素已被单独报道与预后相关。可靠的治疗前预期寿命是重要的，食管癌患者不仅需要考虑肿瘤相关的因素，还需要考虑与宿主相关的因素。方法：回顾分析了356例连续接受手术治疗的患者的临床病理因素：性别、年龄、血清C反应蛋白(CRP)、淋巴细胞比例、体重变化、血清白蛋白、临床TNM分期、肿瘤位置、血清鳞状细胞相关抗原、血清癌胚抗原和组织学。结果：单因素分析显示性别、血清C反应蛋白、淋巴细胞比例、体重变化、血清白蛋白、血清鳞状细胞相关抗原、临床TNM分期在预后方面有显著差异。多因素分析显示，C反应蛋白水平(P=0.0285)、体重变化(P=0.0165)和临床分期(P=0.0008)是影响预后的独立因素。以血清C反应蛋白升高、体重减轻、临床TNM分期III、IV为综合指标时，总评分(食道癌预后指数，PIEC)对预后有较好的分层价值。结论：根据治疗前血清C反应蛋白、体重变化和临床TNM分期，PIEC是一种简便易行的预测食管癌患者预后的方法。
Objective: To identify clinically useful parameters obtainable before treatment of predicting clinical outcomes in patients with esophageal carcinoma.Summary Background Data: Various factors regarding the biologic state of tumors or the nutritional state of patients have been individually reported to correlate with prognosis. Reliable estimates of life expectancy before treatment are important, and consideration needs to be given not only to tumor-related but also to host-related factors in patients with esophageal carcinoma.Methods: The following clinicopathological factors were retrospectively analyzed in 356 consecutive patients with surgical treatment: sex; age; serum C-reactive protein (CRP); proportion of lymphocytes; body weight changes; serum albumin; clinical TNM staging; tumor location; serum squamous cell-related antigen; serum carcinoembryonic antigen; and histology. Factors related to prognosis were evaluated by using univariate and multivariate analyses.Results: According to univariate analysis, significant differences in survival were found for sex, serum CRP, proportion of lymphocytes, body weight change, serum albumin, serum squamous cell-related antigen, and clinical TNM staging. Multivariate analysis demonstrated that CRP levels (P = 0.0285), body weight change (P = 0.0165), and clinical TNM staging (P = 0.0008) displayed independent correlations to prognosis. When serum CRP elevation, body weight loss, and clinical TNM staging III and IV were scored as a combined index, the total score (prognostic index for esophageal cancer, PIEC) demonstrated a good stratification value for prognosis. Moreover, PIEC was superior to the conventional clinical TNM staging by the likelihood ratio test.Conclusions: PIEC based on serum CRP, body weight change, and clinical TNM staging before treatment offers a very simple and informative method for predicting the prognosis of patients with esophageal carcinoma.