Galon免疫评分联合围手术期NRS对结直肠癌患者术后预后的预测价值研究

目的探究Galon免疫评分联合围术期营养风险筛查量表(NRS 2002)对结直肠癌患者术后预后的预测价值。 方法回顾性分析2014年10月至2016年10月接受结直肠癌根治术的97例原发性结直肠癌患者资料。采用统计软件SPSS 21.0进行数据分析，利用Kplan－Meier法及Cox回归模型分析围手术期NRS评分及原发灶Galon免疫评分与结直肠癌患者术后预后的关系及与临床病理特征间的相关性。采用ROC曲线检验联合评分预测模型对结直肠癌患者术后总生存的预测价值，并行Kplan－Meier分析预后，P<0.05为差异有统计学意义。 结果97例入组患者术后1、2、3年累计总生存率分别为95.9%、89.7%、70.1%。围术期NRS评分0分组患者3年总生存率>1分组>2分组(Log－rank χ²＝19.337，P＝0.000)。原发灶Galon免疫评分0分组患者3年总生存率<1分组<2分组<3分组<4分组(Log－rank χ²＝30.511, P＝0.000)。围术期NRS评分联合Galon免疫评分预测结直肠癌术后预后的诊断价值高于单个评分，其AUC值为0.785，灵敏度为65.93%，特异度为84.12%，约登指数为0.501。低危组患者术后3年总生存率优于高危组(Log－rank χ²＝12.517, P＝0.000)。 结论围手术期营养评分联合肿瘤免疫评分对结直肠癌患者预后具有较高预测价值，可在临床中推广应用。

Study on the predictive value of perioperative NRS score and Galon immune score for postoperative prognosis of patients with colorectal cancer

ObjectiveTo explore the predictive value of perioperative NRS score and Galon immune score for postoperative prognosis of patients with colorectal cancer. MethodsRetrospective analysis were performed in 97 patients with colorectal cancer who underwent radical resection from October 2014 to October 2016. Statistical analysis were performed by using SPSS 21.0 software. Kplan-Meier method and Cox regression model were used to analyze the correlation between perioperative NRS score, primary lesion Galon immune score, postoperative prognosis of patients and clinicopathological features. ROC curves were used to test the predictive value of the combined score prediction model for total postoperative survival of patients with colorectal cancer, and Kplan-Meier was used to analyze the prognosis, A P value <0.05 was considered as statistically significant difference. ResultsThe 1-year, 2-year and 3-year cumulative survival rates of 97 enrolled patients were 95.9%, 89.7% and 70.1%, respectively. Compared with perioperative NRS score 1 and 2, Patients with NRS score 0 had a better 3-year overall survival rate (log-rank χ²=19.337, P=0.000). In terms of primary lesion Galon immune score, patients score 0/1/2/3/4 appeared to have a gradually poor 3-year overall survival rate (log-rank χ²=30.511, P=0.000). The value of perioperative NRS score combined with Galon immune score in predicting postoperative prognosis of patients with colorectal cancer was higher than that of a single score, with an AUC value of 0.785, a sensitivity of 65.93%, a specificity of 84.12%, and a yoden index of 0.501. The 3-year overall survival rate of the low-risk group was better than that of the high-risk group (log-rank χ²=12.517, P=0.000). ConclusionPerioperative nutrition score combined with tumor immune score has a high predictive value for prognosis of patients with colorectal cancer, which could be applied in clinical practice.