贵州医科大学学报

2019, v.44;No.224(05) 591-596+605

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HS-mGPS评分对进展期胃癌患者化疗效果与生存状况的预测价值
Predictive Value of HS-mGPS Score on Chemotherapy and Survival in Patients with Advanced Gastric Cancer

陈荣斌;李荣;叶汝兴;李怀;吴楚海;李志兰;
CHEN Rongbin;LI Rong;YE Ruxing;LI Huai;WU Chuhai;LI Zhilan;Oncology Department, Third Affiliated Hospital of Guangdong Medical University, Longjiang Hospital of Shunde District in Foshan City;

摘要(Abstract):

目的:探究高敏感格拉斯哥评分(HS-mGPS)对进展期胃癌患者化疗效果与生存状况的预测价值。方法:选取132例进展期胃癌患者为研究对象,所有患者术前接受mFLOFOX6(奥沙利铂、亚叶酸钙及氟尿嘧啶)方案或SOX(奥沙利铂及替吉奥)方案新辅助化疗,依据患者HS-mGPS评分将其分为0分组、1分组和2分组;比较3组患者化疗疗效和生存状况,并单因素和Logistic多因素分析进展期胃癌患者死亡的相关因素。结果:HS-mGPS评分为0分、1分和2分的患者临床有效率分别为75.30%、50.00%和43.47%,组间比较,差异有统计学意义(P<0.05);化疗后6、12、24月时0分组患者的生存率高于1分组和2分组患者,1分组患者生存率均高于2分组,差异具有统计学意义(P<0.05);单因素分析结果显示,术前伴发疾病、肿瘤M分期、T分期、分化程度、组织分型、化疗疗效、组织学反应、术前营养、HS-mGPS评分、消化道重建方式及术者经验与进展期胃癌患者死亡有关(P<0.05);Logistic多因素分析结果显示,M1分期、高T分期、化疗疗效差、组织学反应低级、HS-mGPS评分高、BillrothⅡ式吻合术及术者经验≤5年为进展期胃癌患者死亡的危险因素(P<0.05)。结论:HS-mGPS得分低的进展期胃癌患者化疗疗效与术后生存状况优于得分高的患者, HS-mGPS评分对进展期胃癌患者化疗效果有预测价值。
Objective: To explore the predictive value of high sensitive modified Glasgow prognostic score(HS-mGPS) for the chemotherapy effect and survival status of patients with advanced gastric cancer. Methods: A total of 132 patients with advanced gastric cancer in our hospital from June 2015 to June 2016 were selected. All patients received mFLOFOX6(Oxaliplatin, leucovorin, fluorouracil) or SOX(Saliplatin and Ticao) before surgery. They were divided into the 0-point group, the 1-point group, and the 2-point group according to the patient's HS-mGPS scores. The curative effect and survival status of the 3 groups were compared, and the single factor and Logistic multivariate analysis were used toobserve the related factors of death in patients with advanced gastric cancer. Results: The clinical response rates of patients with 0, 1 and 2 points of HS-mGPS scores were 75.30%, 50.00% and 43.47% respectively. 6, 12, 24 months after chemotherapy, the survival rate of the 0-point group was higher than that of other 2 groups, and the survival rate of the 1-point group was higher than that of the 2-point group. The difference was statistically significant(P<0.05). Univariate analysis showed preoperative disease, tumor M stage, T stage, differentiation, tissue classification, chemotherapy efficacy, histological response, preoperative nutrition, HS-mGPS score, digestive tract reconstruction, and surgeon experience. It was closely related to the death of patients with advanced gastric cancer(P<0.05). Logistic multivariate analysis showed that M1 stage, high T stage, poor chemotherapy efficacy, low histological response, high HS-mGPS scores, Billroth II anastomosis, and surgeon experience≤5 years were risk factors for the death of patients with advanced gastric cancer(P<0.05).Conclusion: The efficacy of chemotherapy for HS-mGPS and advanced gastric cancer patients is related to the postoperative survival status. Patients with high HS-mGPS scores have lower clinical efficiency of chemotherapy and lower postoperative survival rate. HS-mGPS scores can be applied to the progress in clinical practice, predicting the clinical efficacy and survival of patients with gastric cancer.

关键词(KeyWords): 胃肿瘤;癌;高敏感格拉斯哥评分;化疗;治疗结果;生存状况
gastric neoplasm;carcinoma;high sensitive modified Glasgow prognostic score;chemotherapy;curative results;survival status

Abstract:

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基金项目(Foundation): 广东省自然科学基金(2017A030313540)

作者(Author): 陈荣斌;李荣;叶汝兴;李怀;吴楚海;李志兰;
CHEN Rongbin;LI Rong;YE Ruxing;LI Huai;WU Chuhai;LI Zhilan;Oncology Department, Third Affiliated Hospital of Guangdong Medical University, Longjiang Hospital of Shunde District in Foshan City;

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DOI: 10.19367/j.cnki.1000-2707.2019.05.019

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