老年营养风险指数在进展期胃癌患者根治术后预后评估的临床意义  

Clinical significance of nutritional risk index in elderly patients with advanced gastric cancer after radical resection

作　　者：徐静权 宋维亮[1] Xu Jingquan;Song Weiliang(Department of Gastroenteroanal Surgery,the Third Central Hospital of Tianjin Medical University,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases,Artificial Cell Engineering Technology Research Center,Tianjin Institute of Hepatobiliary Disease,Tianjin 300170,China)

机构地区：[1]天津市第三中心医院胃肠肛肠外科、天津市重症疾病体外生命支持重点实验室、天津市人工细胞工程技术研究中心、天津市肝胆疾病研究所,300170

出　　处：《山西医药杂志》2023年第1期8-12,共5页Shanxi Medical Journal

摘　　要：目的研讨老年营养风险指数(GNRI)对进展期胃癌患者根治术后预后的预测价值。方法回顾性分析2011年1月至2016年12月天津市第三中心医院进行根治性手术切除的老年进展期胃癌患者的临床病理资料。以GNRI风险评估表中评分98为分界值,将纳入的患者分为GNRI正常组和GNRI异常组。应用χ^(2)检验分析GNRI与患者临床病理特征之间的关系,一般临床病理特征和老年营养状况与总生存时间的相关性采用Kaplan-Meier进行分析,组间生存率比较采用Log-Rank检验,应用Cox回归模型进行多因素生存分析。结果GNRI正常组233例(GNRI>98),GNRI异常组35例(GNRI≤98)。GNRI与性别、年龄、血清白蛋白水平、体质指数和肿瘤浸润深度(T)、淋巴结转移(N)、TNM分期均关系密切(P<0.05)。单因素分析表明:血清白蛋白水平、血小板计数/淋巴细胞计数(PLR)、肿瘤浸润深度(T)、淋巴结转移(N)、TNM分期以及GNRI均是影响进展期胃癌患者术后预后的危险因素(P<0.05);多因素分析结果表明,术前GNRI[95%CI=(0.396,0.913),P=0.017]是影响进展期胃癌患者术后预后独立存在的危险因素。结论GNRI可作为术前评估进展期胃癌患者的营养状态以及恶性生物学行为的一项指标,对预测术后患者的生存状况,具有十分重要的临床价值。Objective To investigate the predictive value of nutritional risk index(GNRI)for postoperative prognosis in patients with advanced gastric cancer after radical resection.Methods The clinical pathological data of elderly patients with advanced gastric cancer who underwent radical resection in Tianjin Third Central Hospital from January 2011 to December 2016 were retrospectively analyzed.The patients were divided into normal GNRI group and abnormal GNRI group according to the score 98 in GNRI risk assessment table.Theχ^(2)test was used to analyze the relationship between GNRI and clinical-pathological characteristics of patients.The correlation between general clinical-pathological characteristics and nutritional status of the elderly and total survival time was analyzed by the Kaplan-Meier method.The survival rate between groups was compared by the Log-Rank test.The multivariate survival analysis was performed by Cox regression model.Results There were 233 cases in the GNRI normal group(GNRI>98)and 35 cases in the GNRI abnormal group(GNRI≤98).GNRI was closely related to gender,age,serum albumin level,body mass index(BMI),depth of tumor invasion(T),lymph node metastasis(N)and TNM stage(P<0.05).Univariate analysis showed that serum albumin level,platelet count/lymphocyte count(PLR),tumor invasion depth(T),lymph node metastasis(N),TNM stage and GNRI were all risk factors affecting the postoperative prognosis of patients with advanced gastric cancer(P<0.05).Multivariate analysis showed that preoperative GNRI[95%CI=(0.396,0.913),P=0.017]was an independent risk factor affecting the postoperative prognosis of patients with advanced gastric cancer.Conclusion GNRI can be used as an indicator for preoperative evaluation of nutritional status and malignant biological behavior of patients with advanced gastric cancer,which has very important clinical value for predicting the survival status of postoperative patients.

关 键 词：老年营养风险指数 进展期胃癌 预后 

分 类 号：R735.2[医药卫生—肿瘤]