术前Glasgow预后分数对判断直肠癌预后的价值

目的：探讨术前格拉斯哥预后分数（GPS）对直肠癌手术预后的判断价值。方法：回顾6年半内经手术治疗的219例直肠癌患者的临床资料，分析影响直肠癌患者预后的相关因素，并以术前GPS分值将患者分为GPS 2分组，GPS 1分组和GPS 0分组，分析术前GPS与患者临床病理特征的关系，以及比较3组患者的生存情况。结果：单因素分析显示术前癌胚抗原（CEA），C反应蛋白（CRP），清蛋白水平，TNM分期，GPS与患者总生存时间有关（均P<0.05）；GPS与术前CEA，CA19-9，CA724，CRP，清蛋白水平，Dukes，TNM分期有关（均P<0.05）。单因素Logistic回归分析发现，术前CEA，CA19-9，CA724，CRP，清蛋白水平，肿瘤分化程度，Dukes及TNM分期和GPS与术后死亡有关（均P<0.05），进一步多因素Logistic回归分析提示，术前清蛋白浓度，分化程度，TNM分期和GPS是术后死亡的独立危险因素（均P<0.05）。GPS 2分组，GPS 1分组与GPS 0分组术后5年生存率分别为13.8%，59.9%，88.4%，3组间差异有统计学意义（P<0.001）。结论：术前GPS可作为评估直肠癌术后预后的有效指标。

Prognostic value of preoperative Glasgow prognostic score for rectal cancer

Objective: To determine the prognostic predictive value of preoperative Glasgow prognostic score (GPS) in rectal cancer patients after surgery. Methods: The clinical data of 219 patients with rectal cancer undergoing surgical treatment over the past six and a half years were reviewed. The related factors that affect prognosis were analyzed, and the patients were divided into score-2 group, score-1 group and score-0 group according to their preoperatvie GPS, to analyze the relations of GPS with the clinical features of the patients, and to compare the postoperative survivals among the 3 groups. Results: Univarate analysis showed that the preoperative levels of carcinoembryonic antigen (CEA), C reactive protein (CRP), and albumin, TNM classification and GPS were associated with the overall survival of the patients (all P<0.05); GPS of the patients was relevant to their preoperative levels of CEA, CA19-9, CA724, CRP, and albumin, Dukes’ stage and TNM classification (all P<0.05). Univariate Logistic regression analysis suggested that the preoperative levels of CEA, CA19-9, CA724, CRP, and albumin, differentiation degree of the tumor, Dukes’ stage and TNM classification and GPS were associated with the increased risk of postoperative death (all P<0.05), and further multivariate Logistic regression analysis identified that preoperative albumin level, differentiation degree, TNM classification and GPS were independent risk factors for postoperative death (all P<0.05). The 5-year survival rate of score-2, score-1 and score-0 group was 13.8%, 59.9% and 88.4% respectively, and the difference among them had statistical significance (P<0.001). Conclusion: Preoperative GPS can be used as a prognostic predictor for postoperative survival of rectal cancer patients.