摘要
目的 探讨Naples预后评分(Naples prognostic score,NPS)对食管鳞癌患者根治性放疗预后的预测价值.方法 收集2014 年 1 月至 2018 年 12 月在陕西省肿瘤医院行根治性放疗的 220 例食管鳞癌患者.根据治疗前血清白蛋白、总胆固醇、中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)和淋巴细胞/单核细胞比值(lymphocyte-monocyte ratio,LMR)计算NPS.根据NPS将患者分为低危组(0 分)、中危组(1 或 2 分)和高危组(3 或 4 分).采用Kaplan-Meier法绘制生存曲线并行log-rank检验,采用Cox比例风险回归模型进行单因素和多因素分析.结果 NPS低危组、中危组和高危组患者的 5年总生存(overall survival,OS)率分别为 47.0%、37.7%和 16.3%,5 年无进展生存(progression free survival,PFS)率分别为42.4%、30.4%和 16.2%(均P＜0.01).多因素分析显示,性别、T分期、治疗方式和NPS均是影响患者OS的独立危险因素,而T分期和NPS均是影响患者PFS的独立危险因素(均P＜0.05).结论 治疗前NPS对行根治性放疗的食管鳞癌患者预后有良好预测价值.
Abstract
Objective To evaluate the prognostic value of Naples prognostic score(NPS)in esophageal squamous cell carcinoma patients receiving definitive radiotherapy.Methods The data of 220 esophageal squamous cell carcinoma patients receiving definitive radiotherapy at Shaanxi Provincial Cancer Hospital from January 2014 to December 2018 were collected.NPS was calculated based on serum albumin,total cholesterol,neutrophil-lymphocyte ratio(NLR),and lymphocyte-monocyte ratio(LMR).According to NPS,patients were divided into low-risk group(patients with NPS of 0),middle-risk group(patients with NPS of 1 or 2),and high-risk group(patients with NPS of 3 or 4).Kaplan-Meier curves and log-rank test were used for survival analysis.The prognostic factors of the patients were analyzed by univariate and multivariate Cox regression analysis.Results The 5-year overall survival(OS)rates of patients in the low-,middle-,and high-risk groups were 47.0%,37.7%,and 16.3%,respectively,and the 5-year progression free survival(PFS)rates were 42.4%,30.4%,and 16.2%,respectively(both P＜0.01).Multivariate analysis demonstrated that gender,T stage,treatment modalities,and NPS were independent fac-tors of OS,and T stage and NPS were independent factors of PFS(all P＜0.05).Conclusions Pretreatment NPS has a good predictive value for the prognosis of esophageal squamous cell carcinoma patients receiving definitive radiotherapy.
维普
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