中国普外基础与临床杂志

中国普外基础与临床杂志

Glasgow预后分数与结直肠癌近期疗效

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目的 探讨结直肠癌患者Glasgow预后分数(Glasgow prognostic score,GPS)与短期预后的关系。方法 前瞻性纳入2009年4~6月期间经病理诊断为结直肠癌的住院患者。所有患者均于术前3 d与术后1 d测定血清C反应蛋白及白蛋白水平,并以此计算术前及术后的GPS分值,分析GPS与结直肠癌患者短期预后的关系。结果 本研究共纳入结直肠癌患者38例。术前GPS与病理M分期(P=0.007)和TNM分期(P=0.013)有关,与病理T分期及N分期无关(Pgt;0.05); 术后GPS与病理T、N、M分期与TNM分期均无关(Pgt;0.05)。术前及术后GPS与结直肠癌患者术后生存质量和术后并发症发生情况均无关(Pgt;0.05)。结论 术前GPS与结直肠癌病理M分期与TNM分期有关。机体炎症反应可能不是结直肠癌患者术后近期预后的决定性因素。

Objective To determine the relationships between the preoperative and postoperative Glasgow prognostic score (GPS) and short-term prognosis in colorectal cancer. Methods Patients pathologically verified colorectal cancer were prospectively enrolled at West China Hospital of Sichuan University from April 2009 to June 2009. C-reactive protein (CRP) and albumin (Alb) were examined on the third day before operation and the first day after operation. We calculated the value of GPS and analyzed the relationships between GPS and short-term prognosis. Results This study enrolled 38 patients. Preoperative GPS was significantly related with pathological M stage (P=0.007) and TNM stage (P=0.013), and was not related with T stage and N stage (Pgt;0.05). Postoperative GPS was not related with pathological T, M, N and TNM stages (Pgt;0.05). Moreover, there was no relationship between GPS and postoperative quality of life or complications (Pgt;0.05). Conclusions Preoperative GPS correlates with pathologically M stages and TNM stages. Systematic inflammatory response maybe not the determinant factor for the short-term prognosis of patients with colorectal cancer.

关键词: 结直肠癌; Glasgow预后分数; 术前评估; 预后

Key words: Colorectal cancer; Glasgow prognostic score; Preoperative evaluation; Prognosis

引用本文: 刘丹,汪晓东,邓磊,吕东昊,董慧,牛洁,纳飞飞,李立. Glasgow预后分数与结直肠癌近期疗效. 中国普外基础与临床杂志, 2009, 16(12): 1037-1041. doi: 复制

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1. Ishizuka M, Nagata H, Takagi K, et al. Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer [J]. Ann Surg, 2007; 246(6): 1047-1051.
2. McMillan DC, Wotherspoon HA, Fearon KC, et al. A prospective study of tumor recurrence and the acute-phase response after apparently curative colorectal cancer surgery [J]. Am J Surg, 1995; 170(4): 319-322.
3. McMillan DC, Canna K, McArdle CS. Systemic inflammatory response predicts survival following curative resection of colorectal cancer [J]. Br J Surg, 2003; 90(2): 215-219.
4. Leitch EF, Chakrabarti M, Crozier JE, et al. Comparison of the prognostic value of selected markers of the systemic inflammatory response in patients with colorectal cancer [J]. Br J Cancer, 2007; 97(9): 1266-1270.
5. 汪晓东, 冯硕, 游小林, 等. 结直肠肿瘤多学科协作诊治模式下的随访体系建设 [J]. 中国普外基础与临床杂志, 2007; 14(6): 709-712.
6. Higaki S, Akazawa A, Nakamura H, et al. Metaplastic polyp of the colon develops in response to inflammation [J]. J Gastroenterol Hepatol, 1999; 14(7): 709-714.
7. Miki C, Tonouchi H, Wakuda R, et al. Intra-tumoral interleukin-6 down-regulation system and genetic mutations of tumor suppressor genes in colorectal carcinoma [J]. Cancer, 2002; 94(5): 1584-1592.
8. Roxburgh CS, Salmond JM, Horgan PG, et al. Comparison of the prognostic value of inflammation-based pathologic and biochemical criteria in patients undergoing potentially curative resection for colorectal cancer [J]. Ann Surg, 2009; 249(5): 788-793.
9. Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis [J]. Gut, 2001; 48(4): 526-535.
10. Jaiswal M, LaRusso NF, Burgart LJ, et al. Inflammatory cytokines induce DNA damage and inhibit DNA repair in cholangiocarcinoma cells by a nitric oxide-dependent mechanism [J]. Cancer Res, 2000; 60(1): 184-190.
11. Jackson JR, Seed MP, Kircher CH, et al. The codependence of angiogenesis and chronic inflammation [J]. FASEB J, 1997; 11(6): 457-465.
12. Shiu YC, Lin JK, Huang CJ, et al. Is C-reactive protein a prognostic factor of colorectal cancer? [J]. Dis Colon Rectum, 2008; 51(4): 443-449.
13. Canna K, McArdle PA, McMillan DC, et al. The relationship between tumour T-lymphocyte infiltration, the systemic inflammatory response and survival in patients undergoing curative resection for colorectal cancer [J]. Br J Cancer, 2005; 92(4): 651-654.
14. Beer JH, Haeberli A, Vogt A, et al. Coagulation markers predict survival in cancer patients [J]. Thromb Haemost, 2002; 88(5): 745-749.
15. 汪晓东, 邓磊, 吕东昊, 等. 结直肠癌患者术前SAA、CRP、CEA和CA19-9水平的临床诊断价值 [J]. 四川医学, 2009; 30(3): 340-342.
16. 汪晓东, 高命, 吕东昊, 等. 炎性介质CRP和SAA与肿瘤标记物CEA、CA19-9和CA72-4术前联合评估结直肠癌 [J]. 临床肿瘤学杂志, 2009; 14 (4): 336-340.
17. 吕东昊, 高强, 汪晓东, 等. 多层螺旋CT联合不同炎性反应指标对直肠癌外科决策的随机对照研究 [J]. 中国普外基础与临床杂志, 2009; 16 (10): 851-855.
18. McMillan DC, Elahi MM, Sattar N, et al. Measurement of the systemic inflammatory response predicts cancer-specific and non-cancer survival in patients with cancer [J]. Nutr Cancer, 2001; 41(1-2): 64-69.
19. O’Gorman P, McMillan DC, McArdle CS. Prognostic factors in advanced gastrointestinal cancer patients with weight loss [J]. Nutr Cancer, 2000; 37(1): 36-40.
20. Dixon MR, Haukoos JS, Udani SM, et al. Carcinoembryonic antigen and albumin predict survival in patients with advanced colon and rectal cancer [J]. Arch Surg, 2003; 138(9): 962-966.
21. Scott HR, McMillan DC, Forrest LM, et al. The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer [J]. Br J Cancer, 2002; 87(3): 264-267.
22. Scott HR, McMillan DC, Brown DJ, et al. A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer [J]. Lung Cancer, 2003; 40(3): 295-299.
23. Moyes LH, Leitch EF, McKee RF, et al. Preoperative systemic inflammation predicts postoperative infectious complications in patients undergoing curative resection for colorectal cancer [J]. Br J Cancer, 2009; 100(8): 1236-1239.
24. Staib L, Link KH, Blatz A, et al. Surgery of colorectal cancer: surgical morbidity and five- and ten-year results in 2 400 patients-monoinstitutional experience [J]. World J Surg, 2002; 26(1): 59-66.
25. Ouellette JR, Small DG, Termuhlen PM. Evaluation of Ch-arlson-Age Comorbidity Index as predictor of morbidity and mortality in patients with colorectal carcinoma [J]. J Gastrointest Surg, 2004; 8(8): 1061-1067.
26. Alvarez JA, Baldonedo RF, Bear IG, et al. Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma [J]. Am J Surg, 2005; 190(3): 376-382.