格拉斯哥预后评分对原发性肝癌预后预测价值的初步探讨

目的：探讨术前格拉斯哥预后评分（Glasgow prognostic score，GPS）与原发性肝癌患者肝功能状态及预后的关系。方法97例原发性肝癌患者，根据 GPS 评分不同将患者分为 GPS 0分组、GPS 1分组、GPS 2分组，比较组间患者肝功能状态、肿瘤生物学进展情况以及总体生存时间之间的差异。结果GPS 0分组52例（53．6％），GPS 1分组31例（32．0％），GPS 2分组14例（14．4％）。组间患者的年龄及性别构成无显著性差异（P 均＞0．05），组间患者转氨酶、胆红素及AFP 相比，差异有统计学意义（P 均＜0．05），GPS 评分较高组患者转氨酶、胆红素及 AFP 水平较高；且 GPS 评分较高组患者肿瘤临床病理分期较晚，肝功能 Child-Pugh 分级较差，瘤体更大，多发肿瘤及肿瘤血管侵犯、肝外转移等情况更为多见，上述指标的组间比较差异有统计学意义（P 均＜0．05）。生存分析结果显示，GPS 0分组与 GPS 1分组患者的总体生存时间相比，GPS 0分组患者的生存时间更长，组间差异有统计学意义（P ＝0．013）。结论GPS 评分可能与原发性肝癌患者的肿瘤生物学进展情况、肝功能状态及总体生存情况相关，高 GPS 评分多预示患者进展至病程晚期，肝功能状态较差，预后不良。

Preliminary discussion on prognostic value of Glasgow prognostic score in patients with primary hepatic carcinoma

Objective To investigate the relationship among preoperative Glasgow prognostic score（GPS）,hepatic function and prognosis in patients with primary hepatic carcinoma（PHC）.Methods The clinical data of 97 patients with newly diagnosed PHC were retrospectively evaluated.According to their GPS scores,the patients were divided into 3 groups：the zero-point group,the one-point group and two-point group.Hepatic function,tumor biology and overall survival time were compared among the groups.Results A total of 97 patients were enrolled,including 52 cases（53.6%）in the zero-point group, 31 cases（32.0%）in the one-point group and 14 cases（14.4%）in the two-point group.There were no sig-nificant differences in age and gender composition among the groups（P 〉0.05）.While there existed sig-nificance differences in transaminase,bilirubin and AFP levels among the groups（P 〈0.05 ）.Patients with high GPS were associated with the high level of transaminase,bilirubin and AFP.And advanced clini-cal and pathological stage,poor Child-Pugh class,large tumor size,multiple tumor,vascular invasion and extrahepatic metastasis were more prevalent in these patients.Survival analysis revealed that patients in the zero-point group had a longer overall survival time than that of the one-point group（P =0.013）.Conclu-sion GPS may be associated with tumor biology,hepatic function and overall survival time in patients with PHC.Elevated GPS usually indicates late pathogenesis,poor hepatic function and bad prognosis.