Background: This study aimed to determine whether the prealbumin prognostic score (PPS), a novel indicator using prealbumin instead of albumin in the modified Glasgow Prognostic Score (mGPS), is a better predictive marker postoperatively in patients with gastric cancer.Methods: This retrospective study included consecutive patients who underwent radical gastrectomy for primary pStages I–III gastric cancer between 2006 and 2017. The cutoff values for preoperative prealbumin and C-reactive protein (CRP) were 22 mg/dL and 0.5 mg/dL, respectively. According to the prealbumin and CRP levels, a PPS of zero was defined as both being above the cutoff value, of one as either being below the cutoff value, and of two as both being below the cutoff value.Results: Of the 4663 patients, 3421 (73.4%) had a score of zero, 984 (21.1%) had a score of one, and 258 (5.5%) had a score of two. The higher the PPS, the poorer the overall survival [OS] (p< 0.001). When comparing OS by the PPS in patients with an mGPS of zero, a PPS of one indicated poorer OS than a PPS of zero (p< 0.001). In the multivariate analysis, PPSs of one (hazard ratio [HR]: 1.603; 95% confidence interval [CI]: 1.378–1.866;p< 0.001) and two (HR: 1.322; 95% CI: 1.055–1.656;p= 0.015) were independent poor prognostic factors for OS.Conclusions: The PPS, which is based on a combination of prealbumin and CRP levels, can identify a wider range of patients with poor OS than mGPS in patients with gastric cancer after gastrectomy.
背景：本研究旨在探讨前白蛋白预后评分（PPS）——一种在改良格拉斯哥预后评分（mGPS）中用前白蛋白替代白蛋白的新型指标——是否能更有效地预测胃癌患者术后预后。 方法：本回顾性研究连续纳入2006年至2017年间接受根治性胃切除术的原发性病理分期I–III期胃癌患者。术前前白蛋白和C反应蛋白（CRP）的截断值分别设定为22 mg/dL和0.5 mg/dL。根据前白蛋白和CRP水平，PPS评分定义为：0分（两项指标均高于截断值）、1分（任意一项低于截断值）和2分（两项均低于截断值）。 结果：在4663例患者中，3421例（73.4%）评分为0分，984例（21.1%）评分为1分，258例（5.5%）评分为2分。PPS评分越高，患者总生存期（OS）越差（p<0.001）。在mGPS评分为0分的患者中比较PPS分层OS时，PPS 1分患者的OS显著差于PPS 0分患者（p<0.001）。多因素分析显示，PPS 1分（风险比[HR]：1.603；95%置信区间[CI]：1.378–1.866；p<0.001）和2分（HR：1.322；95% CI：1.055–1.656；p=0.015）均是OS的独立不良预后因素。 结论：基于前白蛋白与CRP联合检测的PPS评分系统，相较于mGPS能更广泛地识别胃切除术后总生存期不良的胃癌患者群体。
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