CONUT评分评估行根治性膀胱切除术的膀胱癌患者预后的临床价值

摘要

Objective To explore the clinical applicative value of controlling nutritional status (CONUT) score in the prediction of survival after cystectomy in patients with bladder cancer.Methods Patients who underwent radical cystectomy (RC) in the First Hospital of Peking University during 2010 and 2011 were enrolled.CONUT score was assessed according to the inclusive criteria.Patients were divided into 2 groups based on the CONUT cutoff of 3.Univariate and multivariate COX analyses were performed to identify the potential prognostic factors for overall survival (OS).Results A total of 189 patients were enrolled,including 90 in the high CONUT group and 99 in the low CONUT group.CONUT score was significantly associ ated with neutrophil/lymphocyte ratio (NLR),platelet/lymphocyte ratio (PLR) and pathological T stage.The median OS was 45.0 months.Univariate COX analysis showed NLR,PLR,pathological T stage,positive lymph node metastasis,vessel inva sion and CONUT score were related to OS of bladder cancer patients.Further multivariate COX analysis revealed CONUT score (HR:2.791;95％ CI:1.258-6.190;P＜0.012) was an independent prognostic index for patients underoing RC.Conclusion CONUT score can serve as a prognostic factor for bladder cancer patients and provide additional information for clinical surgeons to determine on the therapeutic strategy.%目的 初步探讨用术前CONUT评分评估接受根治性膀胱切除术的膀胱癌患者预后的临床价值.方法 搜集2010年至2011年间于北京大学第一医院行根治性膀胱切除术且病理证实为膀胱癌的患者的临床及实验室资料,根据评分标准对每位患者进行CONUT评分,分析影响膀胱癌患者行手术治疗后预后的因素.结果 共有189例膀胱癌患者纳入研究.高CONUT组有90例,低CONUT组有99例,2组的5年总生存率分别为56.0％和86.0％ (P＜0.001).单因素COX分析显示,中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、CONUT评分、肿瘤病理分期、淋巴结转移以及脉管浸润均与膀胱癌患者的预后相关(P均＜0.05).多因素COX分析表明CONUT评分(风险比:2.791;95％置信区间:1.258～6.190;P＜0.012)为影响膀胱癌患者行根治性膀胱切除术预后的独立因素.结论 CONUT是一个评估接受根治性膀胱切除术的膀胱癌患者预后的新指标,具有一定的临床应用价值.