晚期结直肠癌营养指标与化疗预后的相关性分析  

Relationship between nutritional indicator and prognosis in advanced colorectal cancer undergoing chemotherapy

作　　者：贺艳玲 蔡华[1] 张军玲 苏婧 杨瑜明[1] 彭娅[1] He Yanling;Cai Hua;Zhang Junling;Su Jing;Yang Yuming;Peng Ya(Department of Gastroenterology,Hunan Provincial People's Hospital and the First Affiliated Hospital of Hunan Normal University,Changsha 410000,Hunan,China;Department of Head and Neck Internal Medicine,the Hunan Cancer Hospital,Changsha 410000,Hunan,China)

机构地区：[1]湖南省人民医院消化内科/湖南师范大学附属第一医院,长沙410000 [2]湖南省肿瘤医院头颈内科,长沙410000

出　　处：《肿瘤代谢与营养电子杂志》2020年第3期295-300,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：国家自然青年科学基金(81502114);湖南省自然科学基金项目(2016JJ3082);湖南省卫生计生委科研计划课题项目(B2015-84)。

摘　　要：目的探讨体质指数(BMI)、血红蛋白(Hb)、血清白蛋白(ALB)等相关营养指标与晚期结直肠癌化疗预后的关系。方法回顾性分析2013年1月至2018年1月于湖南省肿瘤医院行姑息性手术及术后行化疗治疗的Ⅲ~Ⅳ期结直肠癌患者97例,收集临床病理资料及化疗前后营养指标结果,分析化疗前后各营养指标变化情况及各营养指标水平对患者生存时间的影响。结果①化疗前,超重组与正常组、超重组与低体重组在年龄方面差异具有统计学意义(P<0.001)。Hb水平在不同肿瘤部位间的差异有统计学意义(P=0.029)。②化疗后低体重组和低Hb组患者明显增多,正常组和高Hb组患者减少,差异具有统计学意义(P值分别为0.017、0.007)。③性别、化疗后Hb水平和化疗后ALB水平均对患者预后的影响有统计学意义(均P<0.05),肿瘤分化程度及化疗后BMI水平是影响结直肠癌患者化疗预后的独立危险因素(均P<0.05)。结论①年龄超过60岁的晚期结直肠癌患者更容易出现低体重,结肠癌患者比直肠癌患者更容易出现贫血,此两类患者营养风险更高。②晚期结直肠癌患者化疗后出现低体重、贫血的患者比例较化疗前增大,化疗后营养不良发生率更大。③性别、化疗后ALB及Hb水平是影响晚期结直肠癌化疗预后的危险因素,但不能独立预测其预后;肿瘤分化程度和化疗后BMI水平是影响晚期结直肠癌化疗预后的独立危险因素。Objective To explore the relationship between body mass index,hemoglobin,serum albumin,and prognosis in advanced colorectal cancer patients undergoing chemotherapy.Methods From January 2013 to January 2018,97 patients with stageⅢ-Ⅳcolorectal cancer who underwent palliative operation and postoperative chemotherapy in Hunan cancer hospital were analyzed retrospectively.To collect the clinical pathological data and the results of nutritional indicator pre-and post-chemotherapy,analyze the changes and the effects of nutritional indicator pre-and post-chemotherapy,on the survival time of patients according to the follow-up data.Results①Before chemotherapy,there was a statistically significant difference in age between overweight group and normal weight group,and overweight group and low weight group(P<0.001).The difference in Hb levels between different tumor sites was statistically significant(P=0.029).②After chemotherapy,patients with low weight and low Hb increased significantly,while patients with normal weight and high Hb decreased,the difference was statistically significant(P=0.017,0.007).③Gender、the levels of post-chemotherapy Hb and ALB on the prognosis of patients were statistically significant(P<0.05).Tumor differentiation and post-chemotherapy BMI are independent risk factors that affect the prognosis of patients with colorectal cancer(P<0.05).Conclusion①Advanced colorectal cancer over 60 years of age is more prone to low weight,and patients with colorectal cancer were more prone to have anemia.②The proportion of patients with low weight and anemia increased after chemotherapy,and the incidence of malnutrition was higher in patients with advanced colorectal cancer after chemotherapy.③Gender、the levels of post-chemotherapy ALB and Hb are the risk factors for the prognosis of patients with advanced colorectal cancer,but cannot independently predict the prognosis.Tumor differentiation and post-chemotherapy BMI are independent risk factor for the prognosis of patients with advanced colorect

关 键 词：结直肠癌 化疗 预后 营养指标 

分 类 号：R735.34[医药卫生—肿瘤]