| Objective:To investigate the Prognostic Values of GPS and PNI in advanced n on-small cell lung cancer(NSCLC).Methods: The present study included 219 patients who are first diagnosed as advanced NCSLC in Shandong Provincial Hospital from january 2014 to december2015.Record the patient's age,gender,smoking history,family history,tumor weight changes,pathological type,pathological stage,clinical stage,differentiation degree,tumor size,whether patients with chronic obstructive pneumonia,atelectasis,pleural effusion,recording the patients blood lymphocyte count,Albumin,C reactive protein(CRP)and other test indicators.Then calculate the Glasgow Prognostic score(GPS)and the prognostic nutritional index(PNI).By followed up telephone and outpatient and inpatient patients to statistic overall survival.According to the GPS score and the median of PNI,,it was divided into 0,1 and 2 groups and ascending group and reduction group.To investigate the difference prognosis between GPS score and PNI level with pathological parameters of patients with advanced non-small cell lung cancer.Statistical methods by SPSS 21 software,the continuous variable data expressed by X +s,between the two groups were compared using the t test or F test,single factor analysis using X2 test,survival analysis using the Kaplan-Meier method,to compare the survival rates of log-rank test,multivariate Cox regression analysis was used to model the correlation of survival effect the analysis.Taking a =0.05 as the test standard,the difference was statistically significant when p < 0.05,and the difference was significant when P<0.01 was found.Results:1.Single factor analysis of the effects of each variable on the patient's OSA single factor analysis was carried out between the variables and the patient's survival time.The results showed that the patients' age,sex,the family history of tumor,the type of pleural effusion,the type of tumor,atelectasis,and obstructive pneumonia were not associated with the survival of the advanced SCLC patients(P>0.05).The analysis and comparison of the survival time data between the GPS groups and the GPS evaluation of the patients were found.The higher the score,the shorter the total survival time,the difference was statistically significant(P=0.003),and the PNI high value group OS(average OS 14.271 months)was significantly longer than the low valuegroup(mean OS 12.128 months),the difference was statistically significant(P=0.014);the average total survival time of the smoking group was 12.194 months,while the average survival time of the non smokers was up to 14.186 months.The effect of smoking on the survival time of the patients was statistically significant(P=0.043);the survival time of the patients with significant weight loss was 11.612 months,and the survival time of the patients with no significant loss of weight was 13.523 months(p=0.018),and the difference was statistically significant;CRP was related to the survival period of the patients,and the survival time of the CRP group was shorter(P=0.028 Compared with the maximum diameter of the tumor,the survival period of the maximum diameter >=3cm(OS average 10.842 months)was significantly shorter than that of the <3cm(OS average 16.470 months),and the tumor size was statistically significant(P=0.000)for judging the survival period(P=0.000);the higher the degree of differentiation,the lower the malignancy of the tumor,the longer the survival time(P=0.000),and the IIIb phase.Patients(OS average 17.254 months)were significantly longer than IV patients(OS average 8.971 months),and the difference was statistically significant(P=0.000);the survival time of adenocarcinoma patients(OS average 13.926months)was longer than that of squamous cell carcinoma(OS mean 11.070 months)and other types(OS average 11.075 months).The difference was statistically significant Meaning(P=0.027).2.The effect of multivariate analysis related variables on patients' OSThere were correlations between GPS score(P=0.020),pathological type(P=0.000),differentiation degree(P=0.000),tumor size(P=0.025),clinicopathological stage(P=0.012)and survival time.3.Relationship between GPS score and PNI and clinicopathological parametersThere are no correlation between GPS score and the family history of cancer,pleural effusion,tumor type,tumor size,pathological type,atelectasis and other parameters(P>0.05);But different with age,sex,smoking history,weight loss,chronic obstructive pneumonia,tumor differentiation,clinical pathological staging,it is related.The older,male,smoking,significant weight loss,chronic obstructive pneumonia,differentiation,clinical staging make GPS higher in patients who with worse prognosis(P<0.05).PNI is not associated with age,smoking history,family history of cancer,pleural effusion,tumor type,tumor size,clinical stage,tumor differentiation,and other parameters(P>0.05),and had correlation between gender,weight loss,pathological type,and atelectasis(P<0.05).Also,we thingk the male,significant weight loss,with pulmonary squamous cell carcinoma the patients with lower PNI and poor prognosis.Conclusion: 1.Both GPS and PNI were associated with the prognosis of adva nced NSCLC patients.The higher the GPS score,the lower the PNI,the poorer the prognosis and the shorter the total survival time.2.Smoking,weight loss,differentiation and clinical stage were all related to the prognosis of advanced NSCLC patients in single factor and multiple factors.People who with smoking or weight loss,have a shorter survival time andpoor prognosis;The higher the degree of differentiation,the earlier the clinical stage,the patient's survival period is obviously prolonged,the better prognosis.3.GPS was correlated with survival time in single factor and multiple factors to evaluate late NSCLC.And it is an independent risk factor for evaluating the prognosis of patients with advanced NSCLC.4.Smoking,weight loss,differentiation and clinical stage were independent risk factors for the prognosis of patients with advanced NSCLC. |
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