CONUT评分在FIGO分期ⅠB~ⅡA期宫颈癌患者预后评估中的应用价值  

Clinical value of control nutritional status for the prognostic evaluation of cervical cancer patients with FIGO ⅠB~ ⅡA stage

作　　者：姜丽 钱华[1] 袁冬兰[1] 赵银玲[1] 卜新华[1] Jiang Li;Qian Hua;Yuan Donglan;Zhao Yinling;Bu Xinhua(Department of Obstetrics and Gynecology,Taizhou People’s Hospital,Taizhou 225306 Jiangsu China)

机构地区：[1]泰州市人民医院妇产科,江苏泰州225306

出　　处：《肿瘤代谢与营养电子杂志》2022年第5期665-671,共7页Electronic Journal of Metabolism and Nutrition of Cancer

摘　　要：目的 探讨控制营养状态(CONUT)在宫颈癌患者预后评估中的临床应用价值。方法 将2016年1月至2018年12月于泰州市人民医院接受手术治疗的122例国际妇产科协会(FIGO)分期ⅠB~ⅡA期宫颈癌患者纳入本研究中。以3分为CONUT评分临界值,将所有患者分为CONUT<3分组与CONUT≥3分组。采用χ~2检验或Fisher确切概率法比较两组患者基线特征的分布情况;绘制Kaplan-Meier曲线并计算两组患者的5年总生存(OS)率。通过单、多变量Cox回归分析认定影响宫颈癌患者预后的独立预测因素。结果 CONUT≥3分组患者盆腔淋巴结转移率(42.9%比23.7%,χ~2=4.758,P=0.029)与FIGO分期ⅡA期比例(64.3%比42.5%,χ~2=5.229,P=0.022)较CONUT<3分组明显更高。Kaplan-Meier曲线展示CONUT≥3分与CONUT<3分组患者的5年OS率分别为63.4%和86.6%,差异具有统计学意义(χ~2=11.409,P=0.001)。亚组分析进一步证实CONUT评分可独立于FIGO分期预测宫颈癌患者预后,术前CONUT≥3分提示患者预后不佳(FIGO分期ⅠB期:65.8%比95.5%,χ~2=7.902,P=0.005;FIGO分期ⅡA期:62.7%比76.1%,χ~2=4.206,P=0.043)。单、多因素Cox回归分析表明,术前CONUT评分(HR=3.542,95%CI=1.529~8.207,P=0.008)、肿瘤大小(HR=2.668,95%CI=1.158~6.149,P=0.021)和盆腔淋巴结转移(HR=3.542,95%CI=1.529~8.207,P=0.003)是FIGO分期ⅠB~ⅡA期宫颈癌患者的独立预后因子。结论 CONUT评分是一项评估FIGO分期ⅠB~ⅡA期宫颈癌患者预后的有效工具,具有一定的临床应用价值。Objective To explore the clinical value of controlling nutritional status( CONUT) in the prognostic evaluation of cervical cancer patients.Method A total of 122 FIGO ⅠB~ ⅡA stage patients who received surgical resection for cervical cancer in Taizhou People’s Hospital from January 2016 to December 2018 were included in this study.All patients were divided into CONUT <3 points and CONUT ≥3 according to the CONUT score.The distributions of baseline characteristics between the two groups were compared by χ~2test or Fisher’s exact test.The survival curves were plotted and the 5-year overall survival( OS) rates of patients in CONUT <3points and CONUT ≥3 points group were calculated using Kaplan-Meier curve.Univariate and multivariate Cox regression analysis was conducted to identify the independent prognostic factors for cervical cancer patients.Result The frequency of pelvic lymph node metastasis(42.9% vs 23.7%,χ~2= 4.758,P= 0.029) and the proportion of FIGO ⅡA stage(64.3% vs 42.5%,χ~2= 5.229,P= 0.022)were significantly higher in the CONUT≥3 points group than in the CONUT <3 points group.Kaplan-Meier curve showed that the 5-year OS rates of patients in the CONUT≥3 points and CONUT <3 points group were 63.4% and 86.6%,respectively(χ~2= 11.409,P= 0.001).Subgroup analysis further confirmed that CONUT≥3 points was a significant predictor of poor OS for cervical cancer patients,irrespective of FIGO stage( FIGO ⅠB stage:65.8% vs 95.5%,χ~2= 7.902,P= 0.005;FIGO ⅡA stage:62.7% vs 76.1%,χ~2 = 4.206,P= 0.043).In addition,the univariate and multivariate Cox analysis revealed that preoperative CONUT(HR= 3.542,95%CI= 1.529-8.207,P= 0.008),tumor size(HR= 2.668,95%CI= 1.158-6.149,P= 0.021) and pelvic lymph node metastasis(HR= 3.542,95%CI= 1.529-8.207,P= 0.003) were independent prognostic factors for cervical cancer patients.Conclusion CONUT was an effective tool of prognostic evaluation,and it might have an important clinical value for cervical cancer patients with FIGO ⅠB~ ⅡA stage.

关 键 词：宫颈癌 控制营养状态 营养免疫 预后 预测 

分 类 号：R737.33[医药卫生—肿瘤]