那不勒斯预后评分与初治结直肠癌患者临床病理特征及预后的相关性研究
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R735.34

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内蒙古自治区“草原英才”工程创新创业团队项目; 内蒙古医科大学“致远”人才计划—“治学”二类人才(ZY20241207);


Correlation between Naples prognostic score and clinicopathological fea-tures and prognosis of patients in newly diagnosed colorectal cancer
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    摘要:

    目的:探讨那不勒斯预后评分(NPS)与初治结直肠癌(CRC)患者临床病理特征及预后的相关性。方法:收集188例CRC患者临床病理特征及预后资料。根据治疗前血清ALB(<4 g/dL为1分;≥4 g/dL为0分),TC(≤180 mg/dL为1分;>180 mg/dL为0分),NLR(>2.96为1分;≤2.96为0分),LMR(≤4.44为1分;>4.44为0分)统计NPS累计分值,将患者分为A组(0分)、B组(1~2分)、C组(3~4分),分析各组患者间临床病理特征及预后的差异。结果:各组患者年龄、肿瘤最大直径、神经脉管侵犯、周围血管侵犯、肝脏转移、CA-125、TNM分期、治疗后并发症有统计学差异(P<0.05)。Cox单因素分析显示NPS与患者的OS显著相关(HR=2.477,95%CI:1.468~4.181,P=0.001)。在控制混杂因素后多因素分析显示NPS仍然是独立的预后因素(HR=2.359,95%CI:1.368~4.067,P=0.002)。基于3年OS的K-M曲线提示NPS高分组(C组)预后较差,ROC曲线显示NPS(AUC=0.691)与PNI、SIS、NLR、LMR相比具有更好的预测效能,且NPS+TNM联合模型(AUC=0.833)优于单一TNM分期(AUC=0.792),具有较好的校准能力。结论:NPS能够识别炎症负荷较高、营养状况差的初治CRC患者,是不良预后的独立危险因素,其预测效能高于经典预测评分PNI、SIS、NLR、LMR,与TNM协同使用时可进一步优化分层管理,在治疗前为临床诊疗提供一定价值。

    Abstract:

    Objective:To explore the correlation between the naples prognostic score(NPS)and the clinicopathological characteristics and prognosis of patients with newly diagnosed Colorectal Cancer(CRC).Methods:The clinicopathological char-acteristics and prognosis data of 188 diagnosed CRC patients were collected.The cumulative NPS score was calculated based on the pre-treatment serum ALB(<4 g/dL:1 point,≥4 g/dL:0 point),TC(≤180 mg/dL:1 point,>180 mg/dL:0 point),NLR(>2.96:1 point,≤2.96:0 point),and LMR(≤4.44:1 point,>4.44:0 point).The patients were divided into Group A(0 points),Group B(1~2 points),and Group C(3~4 points),and the differences in clinicopathological characteristics and prognosis among the three groups were analyzed.Results:There were statistically significant differences in age,maximum tumor diameter,neurovascular invasion,perivascular invasion,liver metastasis,CA-125,TNM stage,and post-treatment compli-cations among the NPS groups(P<0.05).Univariate Cox analysis showed that NPS was significantly associated with OS(HR=2.477,95%CI:1.468~4.181,P=0.001).After controlling for confounding factors,multivariate analysis showed that NPS remained an independent prognostic factor(HR=2.359,95%CI:1.368~4.067,P=0.002).The K-M curve based on 3-year OS indicated that the prognosis of the high NPS group(Group C)was worse.The ROC curve showed that NPS(AUC=0.691)had better predictive efficacy compared with PNI,SIS,NLR,and LMR,and the NPS+TNM combined model(AUC=0.833)was superior to the single TNM staging(AUC=0.792),It had a good calibration ability.Conclusion:NPS can identify newly diagnosed CRC patients with high inflammatory load and poor nutritional status.It is an independent risk factor for poor prognosis.Its predictive efficacy is higher than that of the classic predictive scores PNI,SIS,NLR,and LMR.When used in combination with TNM,it can further optimize stratified management and provide certain value for clinical diagnosis and treat-ment before treatment.

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闫万杰;刘彩霞;.那不勒斯预后评分与初治结直肠癌患者临床病理特征及预后的相关性研究[J].川北医学院学报,2025,40(11):1426-1431.

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  • 在线发布日期: 2025-12-22
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