NPS与局部晚期直肠癌新辅助放化疗疗效及预后相关性初步分析

doi:10.3760/cma.j.cn113030-20210706-00249

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摘要目的分析Naples预后评分(NPS)与局部晚期直肠癌(LARC)新辅助治疗疗效相关性及其预测预后价值。方法回顾性分析2015—2020年136例LARC患者资料,搜集并计算新辅助治疗前血清白蛋白、总胆固醇、中性粒细胞与淋巴细胞比值和淋巴细胞与单核细胞比值,根据NPS法则对入组患者进行评分分级。采用Kaplan-Meier法计算生存率,Cox模型多因素预后分析。结果 NPS与LARC新辅助治疗后肿瘤退缩程度及术后pCR无相关性(P=0.192、0.163)。Cox多因素分析显示NPS是LARC的总生存(OS)及无瘤生存(DFS)的独立危险因素(P=0.017、0.003),且分层分析提示评分越低者预后较好;此外,肿瘤大小也是OS的独立危险因素,肿瘤大小与N分期也是DFS的独立危险因素。结论 NPS与LARC新辅助放化疗后肿瘤退缩及pCR无相关性,但能作为LARC治疗长期预后的有效预测指标。

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	朱佳浩
	高其忠
	郭信伟
	刘政操
	杨波
	冀胜军
	赵于天

关键词 ：直肠肿瘤,局部晚期/新辅助放化疗法, Naples预后评分, 预后

Abstract：Objective To analyze the correlation between the Naples prognostic score (NPS) after preoperative neoadjuvant chemoradiotherapy in locally advanced rectal cancer (LARC) and evaluate the prognostic value of NPS in LARC. Methods 136 patients with LARC meeting the recruitment criteria from 2015 to 2020 were selected. Serum albumin, total cholesterol (TC) were collected and neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio were calculated. All patients were scored and graded according to the NPS rule. The survival rate was calculated with Kaplan-Meier method. Multivariate prognostic analysis was performed by Cox models. Results There was no significant correlation between NPS score and tumor regression or pathological complete response (pCR) of LARC patients after neoadjuvant therapy (P=0.192, P=0.163). However, Cox multivariate analysis showed that NPS was an independent risk factor for overall survival (OS) and disease-free survival (DFS) of LARC (P=0.009, P=0.003), and hierarchical analysis suggested that LARC patients with lower NPS score obtained better prognosis. Besides NPS, tumor size was also an independent risk factor for OS, and tumor size and N stage were the independent risk factors for DFS. Conclusion NPS has no correlation with tumor regression or pCR for LARC after neoadjuvant chemoradiotherapy, whereas it could serve as an effective predictor for long-term prognosis of LARC.

Key words： Rectal neoplasm, locally advanced/neoadjuvant chemoradiotherapy Naples prognostic score Prognosis

收稿日期: 2021-07-06

ZTFLH:

基金资助:苏州市肿瘤临床医学中心项目(Szzx201506);无锡市“科教强卫”工程资金项目(FZXK004)

通讯作者: 冀胜军,Email:happy168123@aliyun.com;赵于天,Email:13961730258@139.com

引用本文:

朱佳浩,高其忠,郭信伟等. NPS与局部晚期直肠癌新辅助放化疗疗效及预后相关性初步分析[J]. 中华放射肿瘤学杂志, 2021, 30(12): 1256-1261.

Zhu Jiahao,Gao Qizhong,Guo Xinwei et al. Correlation analysis between Naples prognostic score and treatment outcomes for locally advanced rectal cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(12): 1256-1261.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20210706-00249 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2021/V30/I12/1256

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