黃怡嘉HUANG, YI-CHIA江世偉CHIANG, SHIH-WEISHIH-WEICHIANG營養學系碩士班2026-03-242024-08-1920242024-07-22https://handle.ncl.edu.tw/11296/v5w8c8https://scholars.csmu.edu.tw/handle/123456789/7194大腸直腸癌的盛行率占世界上所有癌症盛行率的十分之一，也是排行在男性第三名以及女性第二名診斷最多的癌症。在老年族群中，根據患者的癌症期別、腫瘤位置、身體健康情況以及治療方式，每個患者的預後不盡相同，因此在判斷預後上存在困難度。雖然發炎反應已被視為腫瘤進展的指標，且許多發炎指標可預測患者的預後，但應用在大腸直腸癌老年患者的結果仍有歧異。本篇研究著眼於五個發炎指標：格拉斯哥預後指數、中性球/淋巴球比值、血小板/淋巴球比值、淋巴球/C反應蛋白比值以及C反應蛋白/白蛋白比值，探討前述發炎指標與大腸直腸癌老年患者的預後相關性。於臺中榮民總醫院嘉義灣橋分院回溯性紀錄2017年至2022年間共106位65歲以上的大腸直腸癌患者。患者於入院住院第一天的年齡、性別、嗜中性球數量、淋巴球數量、血小板數量、C反應蛋白數值、白蛋白數值、腫瘤特性、存活時間以及復發時間，並計算要探討的發炎指標數值。調整干擾因子後，格拉斯哥預後指數大於1時顯著預測較差的整體存活期(adjusted hazard ratio : 3.80, 95% confidence interval (CI) : 1.30 - 11.10, p = 0.015)及疾病無惡化存活期(adjusted hazard ratio : 3.19, 95% CI : 1.34 - 7.57, p = 0.008)。C反應蛋白/白蛋白比值大於1時同樣可預測較差的整體存活期(adjusted hazard ratio : 2.36, 95% CI : 1.01- 5.48, p = 0.046)與疾病無惡化存活期(adjusted hazard ratio : 2.33, 95% CI : 1.14- 4.76, p = 0.02)。本研究結果指出，若65歲以上大腸直腸癌患者的格拉斯哥預後指數以及C反應蛋白/白蛋白比值高時有較差的整體存活期和疾病無惡化存活期，但中性球/淋巴球比值、血小板/淋巴球比值與淋巴球/C反應蛋白比值與大腸直腸癌老年患者的預後無關。Colorectal cancer (CRC) constitutes approximately one-tenth of all cancer cases globally. It ranks as the third most diagnosed cancer in men and the second most diagnosed cancer in women worldwide. It is hard to evaluate the prognosis for elderly patients with CRC due to the variation of individual tumor stages, tumor location, physical condition or treatment modalities. Although inflammation has been considered to be an indicator of tumor progression, and many inflammatory markers could be used to predict a patient’s prognosis, the applications of these markers in elderly patients with CRC are inconsistent. This study aimed to analyze the prognostic significance of the Glasgow prognostic score (GPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/C-reactive protein ratio (LCR), and C-reactive protein/albumin ratio (CAR) in elderly patients with CRC. This was a retrospectively observational study that included patients aged ≥ 65 years with colorectal adenocarcinoma and who were admitted to Taichung Veterans General Hospital (Chiayi branch) between 2017 and 2022. 106 patients were enrolled. Demographic and clinicopathological characteristics, and results of inflammatory indices on day 1 during the hospital stay were recorded from medical records for all patients. Associations between the inflammatory indices, overall survival (OS), and progression-free survival (PFS) were determined using univariate and multivariable Cox proportional3hazard regression analyses. After adjusting for confounders, high GPS level (≥1 vs. 0) significantly predicted poor OS (adjusted hazard ratio (aHR): 3.80, 95% confidence interval (CI): 1.30 - 11.10, p = 0.015) and PFS (aHR: 3.19, 95% CI: 1.34-7.57, p= 0.008). High CAR level (≥1.0 vs. <1) significantly predicted poor OS (aHR: 2.36, 95%CI: 1.01 – 5.48), p=0.046) and PFS (aHR: 2.33, 95% CI: 1.14 – 4.76, p = 0.020). High levels of GPS and CAR, but not NLR, PLR, or LCR, might be potentially useful prognostic indicators for poor OS and PFS in elderly patients with CRC.大腸直腸癌發炎指標整體存活期疾病無惡化存活期Colorectal cancerInflammation indexOverall survivalDisease-free survivalthesis