Study On The Correlation Between Naples Prognostic Score And Prognosis Of Patients With Colorectal Cancer After Radical Resection

BACKGROUND: Colorectal cancer is one of the most common gastrointestinal malignancies threatening human health.With the rapid aging of population and the change of living standards and habits,the incidence of colorectal cancer has been increasing year by year.At present,surgical resection is still the main treatment for colorectal cancer,supplemented by chemotherapy,local radiotherapy,immunization and targeted therapy.With the continuous development of medical technology,although the postoperative survival rate of colorectal cancer has been greatly improved,a new biomarker should be sought to assist in predicting the prognosis of patients,carry out necessary intervention in advance and develop a more comprehensive clinical treatment plan.It is important to improve patient outcomes.The Naples Prognostic Score(NPS)is a novel composite score based on nutritional status and inflammatory immune status,which has been shown to be closely related to the prognosis of many solid tumors.By referring to relevant literature,we can find that there is no domestic report on the correlation between NPS and survival prognosis of colorectal cancer.Therefore,we use this study to further explore the correlation between NPS and prognosis of colorectal cancer patients undergoing radical surgery.OBJECTIVE: By analyzing the relationship between NPS before radical surgery and baseline characteristics and postoperative survival rate in patients with colorectal cancer,we explored the prognostic value of Naples prognostic score for patients with colorectal cancer undergoing radical surgery.METHODS: Data of patients diagnosed with colorectal cancer and receiving radical surgical treatment in Huaihe Hospital of Henan University from January 2016 to December 2018 were retrospectively analyzed.Relevant medical information of patients was collected and recorded: age,sex,body mass index,medical history,tumor site,tumor diameter,tumor differentiation,depth of tumor invasion,lymph node metastasis,distant metastasis,TNM stage,postoperative chemotherapy or not,and hematological examination results within one week before surgery: CEA,serum albumin,total cholesterol,neutrophil count,lymphocyte count,monocyte count,etc.Grouping according to NPS scoring criteria:ALB≥40g/L,TC > 180mg/d L,NLR≤2.96,LMR > 4.44 were all assigned 0 points,and each result with opposite results was assigned 1 point.Finally,Group 0(0 points),Group 1(1～2 points),and Group 2(3～4points)were divided according to the NPS score.Follow-up was conducted by outpatient review,inpatient department system cases and telephone calls.SPSS 26.0 was used for data processing and statistical analysis,and χ2 test was used for comparison among categorical variables.Survival curves were plotted by Kaplan-Meier method,and comparison of survival rates between groups was tested by log-rank method.COX proportional regression model was used to analyze univariate and multivariate prognostic factors affecting the 5-year survival rate of colorectal cancer patients after surgery.When P < 0.05,it was considered statistically significant.RERULTS:A total of 181 patients were included in this study,including 105 males and 76 females,ranging in age from 18 to 87 years old,with an average age of 64.13±12.42 years old.According to the results of NPS score,they were divided into Group 0 Group(35 cases),Group 1 group(86 cases),and Group 2 group(60 cases).χ2 test was used to compare the baseline characteristics of patients in the NPS group,and the results showed that there was statistical significance between NPS and TNM stage,ALB,TC,NLR and LMR(P < 0.05).The results of multivariate analysis showed that CEA,tumor differentiation degree and NPS were independent risk factors for postoperative prognosis of patients with colorectal cancer(P < 0.05).There were significant differences in postoperative survival in Group 0,Group1 and Group 2 of NPS group.With the increase of NPS score,the 5-year postoperative survival rate of patients decreased gradually.NPS can be considered as an independent predictor of postoperative prognosis in patients with colorectal cancer.CONCLUSION: NPS is an independent predictor of postoperative survival in patients with colorectal cancer.There are significant stratification differences in the 5-year postoperative survival rate among NPS subgroups.Therefore,NPS can be used as a routine preoperative examination to evaluate and predict the prognosis of patients with colorectal cancer.Based on the preoperative evaluation results,necessary intervention is carried out in advance and a more comprehensive clinical treatment plan is developed.