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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。
Objective: To investigate the value of preoperative Glasgow prognostic score (GPS) in the prognosis of rectal cancer. Methods: The clinical data of 219 patients with rectal cancer who underwent surgery within 6 and a half years were retrospectively analyzed. The factors influencing the prognosis of patients with rectal cancer were analyzed. The patients were divided into GPS 2 group, GPS 1 group and GPS 0 Grouping, analysis of preoperative GPS and the relationship between the clinicopathological features, and to compare the survival of three groups of patients. Results: Univariate analysis showed preoperative carcinoembryonic antigen (CEA), C-reactive protein (CRP), albumin level, TNM stage and GPS were related to the total survival time of patients (all P <0.05) -9, CA724, CRP, albumin level, Dukes, TNM stage (all P <0.05). Logistic regression analysis showed that preoperative CEA, CA19-9, CA724, CRP, albumin levels, tumor differentiation, Dukes and TNM staging and GPS were related to postoperative death (all P <0.05), and further multivariate Logistic regression Analysis showed that preoperative albumin concentration, degree of differentiation, TNM staging and GPS were independent risk factors for postoperative death (all P <0.05). The 5-year survival rates of GPS 2 group, GPS 1 group and GPS 0 group were 13.8%, 59.9% and 88.4% respectively. The difference between the three groups was statistically significant (P <0.001). Conclusion: Preoperative GPS can be used as a good indicator to evaluate postoperative prognosis of rectal cancer.