四种评估系统对终末期原发性肝癌患者生存预测的初步探讨

肝癌电子杂志 ›› 2020, Vol. 7 ›› Issue (3): 17-21.

四种评估系统对终末期原发性肝癌患者生存预测的初步探讨

杨敏¹, 王超¹, 韩彬彬², 孙瑞¹, 于雷¹, 徐海燕^1,*

1 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院综合科,北京 100021;
2 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院检验科,北京 100021

收稿日期:2020-08-08 发布日期:2020-10-22
通讯作者: *徐海燕 E-mail:xuhaiyan7609@sina.com
作者简介:杨敏,副主任医师,中国医学科学院北京协和医学院肿瘤医院,综合科

Prognostic value of four prognostic tools in end-stage primary liver cancer

Yang Min¹, Wang Chao¹, Han Binbin², Sun Rui¹, Yu Lei¹, Xu Haiyan^1,*

1 Comprehensive Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China;
2 Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

Received:2020-08-08 Published:2020-10-22

摘要/Abstract

摘要： 目的初步探讨格拉斯哥预后评分（glasgow prognostic score, GPS）、预后营养指数（prognostic nutritional index,PNI）、终末期肝病模型(model for end-stage liver disease, MELD)评分与WPCBAL评分这四个预后评估系统对终末期原发性肝癌（primary liver cancer, PLC）患者生存时间的预测效能。方法回顾性分析2010年1月至2020年4月住院死亡的50例终末期PLC患者的临床资料。收集患者末次入院的基本信息并进行GPS、PNI、MELD评分与WPCBAL评分。应用log-rank检验比较不同评估系统分组之间患者生存时间的差异。采用受试者工作特征曲线( receiver operating characteristic curve, ROC曲线)评价不同预后系统对于终末期肝癌患者3周生存状态的预测效能。结果 50例终末期肝癌患者末次入院后中位生存时间为9.5d（95%CI：6~15d）,入院后3周死亡率为80.0%。log-rank检验显示：MELD评分≥15分组比MELD评分<15分组生存时间更短（7d比16d,P = 0.002）,WPCBAL得分≥5分组比WPCBAL得分<5分组生存时间更短（7d比10d,P = 0.029）。ROC曲线检测显示：MELD评分与WPCBAL评分预测终末期PLC患者3周生存状况的曲线下面积(area under the curve, AUC)分别为0.7325（95%CI：0.5571~0.9079）、0.6838（95%CI：0.5188~0.8487）。结论 MELD评分及WPCBAL评分对于终末期PLC患者短期生存状态预测具有一定价值,但是灵敏度低。

关键词: 原发性肝癌, 终末期肝病, 预后

Abstract: Objective: To evaluate the prognostic value of glasgow prognostic score(GPS), prognostic nutritional index (PNI), model for end-stage liver disease(MELD) score and WPCBAL score in end-stage primary liver cancer(PLC) patients. Methods: Clinical data of 50 end-stage PLC patients discharged dead from the Cancer Hospital of the Chinese Academy of Medical Sciences between January 2010 to April 2020 were retrospectively analyzed. The general information and scores of four prognostic tools on last admission were collected. Differences of survival time among prognostic tools were compared by the log-rank test. Predictive values of various prognostic tools for 3-week mortality were evaluated by the receiver operating characteristic curve(ROC) analysis. Results: The median survival time was 9.5 days (95% CI: 6 ~15 days), and the 3-week mortality rate was 80.0%. Log-rank test showed that the survival time of MELD score≥ 15 group was shorter than MELD score < 15 group (7d vs. 16d, P = 0.002), and WPCBAL score≥ 5 group had a shorter survival time than WPCBAL score < 5 group (7d vs. 10d, P = 0.029). ROC analysis showed that the area under the ROC (AUC) of MELD score and WPCBAL score in predicting 3 week survival of patients with end-stage liver cancer were 0.7325 (95% CI: 0.5571~0.9079) and 0.6838 (95% CI: 0.5188~0.8487), respectively. Conclusion: MELD score and WPCBAL score are valuable in predicting the short-term survival status of end-stage PLC patients with low sensitivity.

Key words: Primary liver cancer, End-stage liver disease, Prognosis

杨敏, 王超, 韩彬彬, 孙瑞, 于雷, 徐海燕. 四种评估系统对终末期原发性肝癌患者生存预测的初步探讨[J]. 肝癌电子杂志, 2020, 7(3): 17-21.

Yang Min, Wang Chao, Han Binbin, Sun Rui, Yu Lei, Xu Haiyan. Prognostic value of four prognostic tools in end-stage primary liver cancer[J]. Electronic Journal of Liver Tumor, 2020, 7(3): 17-21.

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