营养风险指数在Ⅳ期胃癌预后评价中的意义  

Prognostic significance of nutritional risk index in stage Ⅳ gastric cancer

作　　者：孙政 阙海峰 楼建[2] 徐宏涛 SUN Zheng;QUE Haifeng;LOU Jian(Department of General Surgery,the Central Hospital of Lishui,Zhejiang,Lishui 323000,China)

机构地区：[1]浙江省丽水市中心医院胃肠外科,323000 [2]浙江省丽水市中心医院肿瘤内科,323000

出　　处：《临床外科杂志》2022年第1期58-61,共4页Journal of Clinical Surgery

摘　　要：目的评估营养风险指数(NRI)对Ⅳ期胃癌预后的影响。方法 2011年10月~2015年10月我院确诊为Ⅳ期胃癌的病人107例,通过计算NRI,将NRI<97.5定义为营养不良,分析病人年龄、性别、肿瘤部位、转移部位、体重指数(BMI)以及NRI与病人总生存时间的相关性;并对化疗后病人重新评估NRI,分析NRI变化与总生存时间的相关性。结果通过Kaplan-Meier方法分析,病人的年龄、性别、肿瘤部位及治疗方案与病人的总生存时间无明显相关性(P>0.05)。病人肿瘤转移部位与总生存时间相关,差异有统计学意义(P<0.05)。通过多因素Cox回归分析,BMI(P=0.017)和NRI(P=0.025)是病人预后不良的独立因素。在化疗亚组分析中,初次评估时没有营养不良但在化疗期间营养不良的病人的总体生存时间明显较差(17个月vs 13个月,χ^(2)=4.366,P=0.037)。而初次评估时营养不良且仍然营养不良的病人的生存时间在统计学上并无显著差异(9个月vs 10个月,χ^(2)=0.269,P=0.604)。结论 NRI是Ⅳ期胃癌病人独立的预后因素,在化疗亚组中,营养不良的病人较营养良好的病人总生存期明显缩短。NRI可作为营养评估的工具。Objective Malnutrition is a poor prognostic factor for many tumors.The current research mainly focuses on locally resectable or radical resectable gastric cancer.The purpose of this study was to investigate the effect of the nutritional risk index(NRI) on the prognosis of stage IV gastric cancer.Methods 107 patients with civ gastric cancer diagnosed in Lishui Central Hospital from October 2011 to October 2015 were selected.By calculating the NRI,NRI < 97.5 was defined as malnutrition, and the correlation between age, gender, tumor location, metastasis location, body weight, body height index(BMI) and NRI,and the overall survival time of patients was analyzed.The NRI of patients after chemotherapy was reevaluated, and the relationship between the change of NRI and the overall survival time has been analyzed The correlation of survival time.Result Kaplan-Meier analysis showed that there was no significant correlation between age, gender, tumor location and treatment regimen and overall survival time(P>0.05).There was a significant correlation between tumor metastasis site and overall survival time(P<0.05).Cox regression analysis showed that BMI(P=0.017) and NRI(P=0.025) were independent factors of poor prognosis.In the chemotherapy subgroup analysis, the overall survival time of patients without malnutrition at the initial evaluation but with malnutrition during chemotherapy was significantly worse(17 months vs 13 months, χ^(2)=4.366,P=0.037).However, there was no significant difference in the survival time of patients with malnutrition and still malnutrition at the initial assessment(9 months vs 10 months, χ^(2)= 0.269,P=0.604).Conclusion NRI is an independent prognostic factor for patients with newly diagnosed stage IV gastric cancer, and in the chemotherapy subgroup, the overall survival of patients with malnutrition is significantly shorter than that of patients with good nutrition.NRI can be used as a nutritional assessment tool to help doctors to develop better treatment strategies.

关 键 词：营养风险指数 Ⅳ期胃癌 预后 COX回归 

分 类 号：R735.2[医药卫生—肿瘤]