CAJ | 학술논문

目的：探讨术前格拉斯哥预后评分（Glasgow prognostic score，GPS）与原发性肝癌患者肝功能状态及预后的关系。方法97例原发性肝癌患者，根据 GPS 评分不同将患者分为 GPS 0分组、GPS 1分组、GPS 2分组，比较组间患者肝功能状态、肿瘤生物学进展情况以及总体生存时间之间的差异。结果GPS 0分组52例（53．6％），GPS 1分组31例（32．0％），GPS 2分组14例（14．4％）。组间患者的年龄及性别构成无显著性差异（P 均＞0．05），组间患者转氨酶、胆红素及AFP 相比，差异有统计学意义（P 均＜0．05），GPS 评分较高组患者转氨酶、胆红素及 AFP 水平较高；且 GPS 评分较高组患者肿瘤临床病理分期较晚，肝功能 Child-Pugh 分级较差，瘤体更大，多发肿瘤及肿瘤血管侵犯、肝外转移等情况更为多见，上述指标的组间比较差异有统计学意义（P 均＜0．05）。生存分析结果显示，GPS 0分组与 GPS 1分组患者的总体生存时间相比，GPS 0分组患者的生存时间更长，组间差异有统计学意义（P ＝0．013）。结论GPS 评分可能与原发性肝癌患者的肿瘤生物学进展情况、肝功能状态及总体生存情况相关，高 GPS 评分多预示患者进展至病程晚期，肝功能状态较差，预后不良。
목적：탐토술전격랍사가예후평분（Glasgow prognostic score，GPS）여원발성간암환자간공능상태급예후적관계。방법97례원발성간암환자，근거 GPS 평분불동장환자분위 GPS 0분조、GPS 1분조、GPS 2분조，비교조간환자간공능상태、종류생물학진전정황이급총체생존시간지간적차이。결과GPS 0분조52례（53．6％），GPS 1분조31례（32．0％），GPS 2분조14례（14．4％）。조간환자적년령급성별구성무현저성차이（P 균＞0．05），조간환자전안매、담홍소급AFP 상비，차이유통계학의의（P 균＜0．05），GPS 평분교고조환자전안매、담홍소급 AFP 수평교고；차 GPS 평분교고조환자종류림상병리분기교만，간공능 Child-Pugh 분급교차，류체경대，다발종류급종류혈관침범、간외전이등정황경위다견，상술지표적조간비교차이유통계학의의（P 균＜0．05）。생존분석결과현시，GPS 0분조여 GPS 1분조환자적총체생존시간상비，GPS 0분조환자적생존시간경장，조간차이유통계학의의（P ＝0．013）。결론GPS 평분가능여원발성간암환자적종류생물학진전정황、간공능상태급총체생존정황상관，고 GPS 평분다예시환자진전지병정만기，간공능상태교차，예후불량。
Objective To investigate the relationship among preoperative Glasgow prognostic score(GPS),hepatic function and prognosis in patients with primary hepatic carcinoma(PHC).Methods The clinical data of 97 patients with newly diagnosed PHC were retrospectively evaluated.According to their GPS scores,the patients were divided into 3 groups:the zero-point group,the one-point group and two-point group.Hepatic function,tumor biology and overall survival time were compared among the groups.Results A total of 97 patients were enrolled,including 52 cases(53.6%)in the zero-point group, 31 cases(32.0%)in the one-point group and 14 cases(14.4%)in the two-point group.There were no sig-nificant differences in age and gender composition among the groups(P >0.05).While there existed sig-nificance differences in transaminase,bilirubin and AFP levels among the groups(P <0.05 ).Patients with high GPS were associated with the high level of transaminase,bilirubin and AFP.And advanced clini-cal and pathological stage,poor Child-Pugh class,large tumor size,multiple tumor,vascular invasion and extrahepatic metastasis were more prevalent in these patients.Survival analysis revealed that patients in the zero-point group had a longer overall survival time than that of the one-point group(P =0.013).Conclu-sion GPS may be associated with tumor biology,hepatic function and overall survival time in patients with PHC.Elevated GPS usually indicates late pathogenesis,poor hepatic function and bad prognosis.