NRS2002和PNI营养筛查方法在胃癌患者预后中的预测价值  

Predictive value of NRS2002 and PNI nutritional screening methods in the prognosis of patients with gastric cancer

作　　者：把明勤 陈柳 朱小琼 胡孔旺[3] 赵存喜[1] BA Minqing;CHEN Liu;ZHU Xiaoqiong;HU Kongwang;ZHAO Cunxi(School of Public Health,Anhui Medical University,Hefei,Anhui 230032,China)

机构地区：[1]安徽医科大学公共卫生学院,安徽合肥230032 [2]安徽省肿瘤医院普外科,安徽合肥230031 [3]安徽医科大学第一附属医院普外科,安徽合肥230022

出　　处：《中华全科医学》2023年第7期1121-1124,1247,共5页Chinese Journal of General Practice

基　　金：安徽省重点研究与开发计划项目(202004j07020036)。

摘　　要：目的比较营养风险筛查2002(NRS2002)和预后营养指数(PNI)两种营养筛查方法在胃癌短期预后中的预测价值。方法选取2021年4月—2022年5月安徽省肿瘤医院就诊且进行手术的381例胃癌患者,使用NRS2002和PNI进行术前营养评估,分析与胃癌患者一般临床资料及预后之间的关系;二元logistic回归分析研究营养不良的影响因素。采用受试者工作特征(ROC)曲线下面积(AUC)比较2种方法的预测价值。结果NRS2002进行术前营养评估得出年龄、TNM分期、分化程度是预后独立影响因素;PNI进行术前营养评估得出患者营养状况与年龄、TNM分期和分化程度是预后独立影响因素。NRS2002和PNI两种营养筛选方法均得出有营养风险组术后住院时间[(11.57±3.73)d vs.(10.19±2.66)d;(11.63±3.65)d vs.(10.16±2.68)d]、住院费用[(51078±9204)元vs.(45574±2406)元;(50796±8992)元vs.(45635±8234)元)及术后并发症发生率高于无营养风险组,差异有统计学意义(均P<0.05)。NRS2002(AUC=0.73)预测效果略优于PNI(AUC=0.68)。结论NRS2002和PNI两种营养评价方法在预测胃癌患者短期预后方面具有临床价值,且NRS2002的特异度及灵敏度高于PNI。Objective To compare the predictive value of nutritional risk screening 2002(NRS2002)and prognostic nutritional index(PNI)in the short-term prognosis of gastric cancer.Methods A total of 381 gastric cancer patients who attended Anhui Cancer Hospital and underwent surgery from April 2021 to May 2022 were selected for preoperative nutritional assessment using NRS2002 and PNI to analyze the relationship with general clinical information and prognosis of gastric cancer patients.Binary logistic regression was used to analyze the influencing factors of malnutrition.The predictive value of two methods was compared using the area under the receiver operating characteristic(ROC)curve(AUC).Results Preoperative nutritional assessment by NRS2002 found that age,TNM stage,and degree of differentiation were independent prognostic factors.Preoperative nutritional assessment by PNI revealed that the patient's nutritional status,age,TNM stage,and degree of differentiation were independent prognostic factors.Both nutritional screening methods showed that the postoperative hospitalization time[(11.57±3.73)days vs.(10.19±2.66)days;(11.63±3.65)days vs.(10.16±2.68)days)],hospitalization costs[(51078±9204)￥vs.(45574±2406)￥;(50796±8992)￥vs.(45635±8234)￥,and postoperative complication rate in the group with nutritional risk were higher than those in the group without nutritional risk,and the difference was statistically significant(all P<0.05).The prediction effect of NRS2002(AUC=0.73)was slightly better than that of PNI(AUC=0.68).Conclusion NRS2002 and PNI nutritional evaluation methods have clinical value in predicting short-term prognosis of gastric cancer patients,and NRS2002 has higher specificity and sensitivity than PNI.

关 键 词：预后营养指数 营养风险筛查2002 胃癌 并发症 

分 类 号：R735.2[医药卫生—肿瘤] R459.3[医药卫生—临床医学]