高灵敏度改良格拉斯哥预后评分(HS-mGPS)是小管型肝内胆管癌的预后生物标志物-一项回顾性队列研究。

IF 1.5 4区 医学 Q4 ONCOLOGY
Translational cancer research Pub Date : 2025-02-28 Epub Date: 2025-02-24 DOI:10.21037/tcr-24-917
Xintao He, Zixin Liang, Shuo Zhang, Youxiang Ding, Xiaoping Qian, Hongyan Wu, Jun Chen
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引用次数: 0

摘要

背景:血清生物标志物常被用作术前预测策略的一部分,以帮助评估患者的手术风险和预后。与传统的格拉斯哥预后评分(GPS)和改良的格拉斯哥预后评分(mGPS)相比,高灵敏度改良格拉斯哥预后评分(HS-mGPS)在各种癌症中具有更好的预测准确性,但其预测肝内胆管癌(ICC)患者预后的能力尚未得到充分研究。本研究的目的是探讨HS-mGPS在ICC及其亚型中的预后价值。方法:本研究为单中心回顾性研究。所有2012 - 2022年南京鼓楼医院手术后病理诊断为ICC的患者。相关实验室数据包括血清c反应蛋白(CRP)、白蛋白(ALB)、中性粒细胞、淋巴细胞和血小板。收集总生存期(OS)信息,采用血清CRP和ALB水平对GPS、mGPS和HS-mGPS进行评分。采用Kaplan-Meier (KM)曲线和Cox比例风险模型进行单因素和多因素分析,确定影响预后的因素。此外,通过组织学分析,将ICC分为大风管型(LD-type)和小风管型(SD-type),并对三种评分系统在这两种亚型中的表现进行检验。结果:本研究共纳入185例患者,ld型57例,sd型128例。肿瘤亚型是所有ICC患者预后的重要影响因素[危险比(HR) =1.76, 95%可信区间(CI): 1.036 ~ 2.994, P=0.04]。与GPS和mGPS相比,HS-mGPS具有更好的预测预后的能力,是OS的独立预后因素(HR =2.1, 95% CI: 1.001 ~ 4.374, P=0.049)。与GPS和mGPS相比,HS-mGPS对sd型ICC的预后预测更有效(HR =3.13, 95% CI: 1.018-9.604, P=0.046),而对ld型ICC的预后预测无效。进一步分析发现,HS-mGPS评分较高的sd型ICC通常肿瘤较大,分化程度较差,而ld型ICC无显著差异。结论:HS-mGPS对sd型提供了更准确的预后指征,但其对ld型的有效性有待于更大样本量的进一步研究。因此,对于术前活检诊断的sd型ICC, HS-mGPS具有一定的预后预测潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
High-sensitivity modified Glasgow prognostic score (HS-mGPS) is a prognostic biomarker for small duct-type intrahepatic cholangiocarcinoma-a retrospective cohort study.

Background: Serum biomarkers are often used as part of preoperative prediction strategies to help assess a patient's surgical risk and prognosis. The high-sensitivity modified Glasgow prognostic score (HS-mGPS) has been shown to offer better predictive accuracy compared to the traditional Glasgow prognostic score (GPS) and the modified Glasgow prognostic score (mGPS) in various cancers, but its ability to predict outcomes in patients with resected intrahepatic cholangiocarcinoma (ICC) has not been well-studied. The aim of the study was to investigate the prognostic value of HS-mGPS in ICC and its subtypes.

Methods: This study was a single-center retrospective study. All patients who were pathologically diagnosed with ICC after surgery in Nanjing Drum Tower Hospital from 2012 and 2022. Relevant laboratory data such as serum C-reactive protein (CRP), albumin (ALB), neutrophils, lymphocytes, and platelets were included. Overall survival (OS) information was collected, serum CRP and ALB level were used for scoring GPS, mGPS and HS-mGPS. Univariate and multivariate analyses were conducted to identify factors influencing prognosis by using Kaplan-Meier (KM) curve and Cox proportional hazards models. Additionally, through histological analysis, ICC was classified into large duct type (LD-type) and small duct type (SD-type), and the performance of the three scoring systems in these subtypes was examined.

Results: A total of 185 patients were included in this study, 57 cases were of the LD-type, and 128 cases were of the SD-type. Tumor subtypes was a significant factor influencing prognosis for all ICC patients [hazard ratio (HR) =1.76, 95% confidence interval (CI): 1.036-2.994, P=0.04]. HS-mGPS demonstrated a better ability to predict outcomes compared to GPS and mGPS, and was an independent prognostic factor of OS (HR =2.1, 95% CI: 1.001-4.374, P=0.049). HS-mGPS was also more effective in predicting prognosis for SD-type ICC compared to GPS and mGPS (HR =3.13, 95% CI: 1.018-9.604, P=0.046), while it was ineffective for LD-type ICC. Further analysis revealed that SD-type ICC with higher HS-mGPS scores typically had larger tumors and poorer differentiation, while LD-type ICC showed no significant differences.

Conclusions: HS-mGPS provides a more accurate prognostic indication for SD-type, but its effectiveness for LD-type requires further investigation with larger sample sizes. Therefore, for preoperatively biopsy-diagnosed SD-type ICC, the HS-mGPS has a certain level of prognostic predictive potential.

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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
252
期刊介绍: Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.
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