Prognostic value of preoperative immune-nutritional scoring systems in remnant gastric cancer patients undergoing surgery  

作　　者：Yan Zhang Lin-Jun Wang Qin-Ya Li Zhen Yuan Dian-Cai Zhang Hao Xu Li Yang Xin-Hua Gu Ze-Kuan Xu 

机构地区：[1]Department of Gastrointestinal Surgery,Suzhou Municipal Hospital,Affiliated Suzhou Hospital of Nanjing Medical University,Gusu School of Nanjing Medical University,Suzhou 215000,Jiangsu Province,China [2]Department of General Surgery,Jiangsu Province Hospital,First Affiliated Hospital of Nanjing Medical University,Nanjing 210003,Jiangsu Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2023年第2期211-221,共11页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by National Natural Science Foundation of China,No.81871946 and No.82072708;Suzhou Medical Key Discipline,No.SZXK202109;Suzhou Clinical Key Diseases Project,No.LCZX202111;Project of Gusu School of Nanjing Medical University,No.GSKY20210233.

摘　　要：BACKGROUND Remnant gastric cancer(GC)is defined as GC that occurs five years or more after gastrectomy.Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer(RGC)patients are crucial.A simple scoring system that combines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary.AIM To evaluate the value of preoperative immune-nutritional scoring systems in predicting the prognosis of patients with RGC.METHODS The clinical data of 54 patients with RGC were collected and analyzed retrospectively.Prognostic nutritional index(PNI),controlled nutritional status(CONUT),and Naples prognostic score(NPS)were calculated by preoperative blood indicators,including absolute lymphocyte count,lymphocyte to monocyte ratio,neutrophil to lymphocyte ratio,serum albumin,and serum total cholesterol.Patients with RGC were divided into groups according to the immune-nutritional risk.The relationship between the three preoperative immune-nutritional scores and clinical characteristics was analyzed.Cox regression and Kaplan–Meier analysis was performed to analyze the difference in overall survival(OS)rate between various immune-nutritional score groups.RESULTS The median age of this cohort was 70.5 years(ranging from 39 to 87 years).No significant correlation was found between most pathological features and immune-nutritional status(P>0.05).Patients with a PNI score<45,CONUT score or NPS score≥3 were considered to be at high immune-nutritional risk.The areas under the receiver operating characteristic curves of PNI,CONUT,and NPS systems for predicting postoperative survival were 0.611[95%confidence interval(CI):0.460–0.763;P=0.161],0.635(95%CI:0.485–0.784;P=0.090),and 0.707(95%CI:0.566–0.848;P=0.009),respectively.Cox regression analysis showed that the three immunenutritional scoring systems were significantly correlated with OS(PNI:P=0.002;CONUT:P=0.039;NPS:P<0.001).Surv

关 键 词：Remnant gastric cancer Immune-nutritional score Prognostic nutritional index Controlled nutritional status Naples prognostic score 

分 类 号：R735.2[医药卫生—肿瘤]