摘要
背景结直肠癌(colorectal cancer,CRC)预后评估需有效的生物标志物.鉴于现有炎症指标预测效能存在局限,本研究假设术前改良中性粒细胞血小板评分(modified neutrophil-platelet score,MNPs)可独立预测CRC患者总生存期(overall survival,OS)和无复发生存期(recurrence free survival,RFS).目的探究术前MNPs与CRC患者预后的预测价值.方法回顾性分析哈尔滨医科大学附属第二医院普外科2016-10/2018-12的503例CRC患者的临床资料,随访5年,记录CRC患者的预后情况.分析不同MNPs与OS和RFS的关联.采用Kaplan Meier法绘制生存曲线,Cox比例风险回归模型评价CRC患者预后的影响因素,并计算C指数评估MNPs与其他炎症指标的预测效能差异.结果共503例CRC患者纳入本研究.单因素Cox回归分析结果显示,MNPs与OS相关,MNPs评分越高死亡风险越高;MNPs与RFS相关,MNPs评分越高复发风险越高.多因素分析表明,MNPs为OS、RFS独立预测因子.C指数表明,MNPs对CRC患者的预后具有较好的预测能力.结论MNPs是预测CRC患者预后的独立因素,临床医师可通过检测术前MNPs为早期恶性肿瘤高危和复发转移患者提供更为个性化、精准的治疗方案.
BACKGROUND Effective biomarkers are needed for the prognosis assessment of colorectal cancer(CRC).Given the limitations of existing inflammatory markers in predictive efficacy,we hypothesized that preoperative modified neutrophil-platelet score(MNPS)can independently predict overall survival(OS)and recurrence-free survival(RFS)in CRC patients.AIM To explore the value of preoperative MNPS for predicting the prognosis of patients with CRC.METHODS A retrospective analysis was conducted on the clinical data of 503 CRC patients admitted to the Department of General Surgery of the Second Affiliated Hospital of Harbin Medical University between October 2016 and December 2018.These patients were followed up for a period of 5 years,and their prognoses were recorded.The association of MNPS with OS and RFS was then analyzed.The Kaplan-Meier method was used to plot survival curves,Cox proportional hazards regression model was used to evaluate the influencing factors of prognosis in CRC patients,and the C-index was calculated to assess the difference in predictive efficacy between MNPS and other inflammatory indicators.RESULTS A total of 503 patients with CRC were included in this study.The results of univariate Cox regression analysis showed that MNPS was associated with both OS and RFS,with higher MNPS indicating a higher risk of mortality and recurrence.Multivariate analysis revealed that MNPS served as an independent predictor of both OS and RFS.The C-index indicated that MNPS demonstrated superior predictive efficacy for the prognosis of CRC patients.CONCLUSION MNPS is an independent factor for predicting the prognosis of CRC patients.Clinicians can provide more personalized and accurate treatment plans for early-stage high-risk and recurrent metastatic patients by detecting preoperative MNPS.
作者
唐研
宗柏安
张好刚
Yan Tang;Bo-An Zong;Hao-Gang Zhang(Department of General Surgery,The Second Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang Province,China)
出处
《世界华人消化杂志》
2025年第8期674-684,共11页
World Chinese Journal of Digestology
基金
黑龙江省博士后科研启动金,No.LBH-Q21026
黑龙江省中医药管理局课题,No.zhy 2020-169.
