术前BMI与可切除胃癌患者术后远期生存的关系  

Relationship between preoperative BMI and postoperative complications and long-term survival in patients with resectable gastric cancer

作　　者：宋钰[1] 赵阳[1] 王惠君[1] 廖新华[1] Song Yu;Zhao Yang;Wang Huijun;Liao Xinhua(Department of General Surgery,the First Affiliated Hospital Xi’an Jiao Tong University,Xi’an Shaanxi Province 710061,China)

机构地区：[1]西安交通大学第一附属医院普通外科,西安710061

出　　处：《中华普外科手术学杂志（电子版）》2023年第5期530-533,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：陕西省2021年重点研发计划项目(2021SF-123)。

摘　　要：目的:分析术前体重指数(BMI)与可切除胃癌患者术后远期生存的关系。方法:回顾性分析2015年1月至2017年5月389例行胃癌根治术患者临床资料,根据BMI标准分为三组,包括低BMI组44例、正常组199例和高BMI组146例,分析术前BMI与胃癌患者术后远期生存的关系。采用SPSS 22.0进行数据分析,计数资料比较行χ^(2)检验;计量资料用(^(-)x±s)表示,多组间比较行单因素方差分析,组间两两比较采用LSD检验;采用COX风险比例模型对术后远期生存的影响因素进行分析。P<0.05为差异具有统计学意义。结果:三组患者性别、合并糖尿病、淋巴结清扫数、术后并发症等临床资料比较,差异具有统计学意义(P<0.05)。低BMI组患者5年总生存率显著低于正常组和高BMI组(44.7%vs.77.4%,44.7%vs.81.5%),差异具有统计学意义(P<0.05),正常组与高BMI组比较(77.4%vs.81.5%),差异无统计学意义(P>0.05)。胃癌患者远期生存的单因素COX回归分析结果显示:年龄、合并糖尿病、肿瘤位置、肿瘤直径、分化程度、pN分期、pT分期、脉管癌栓、神经侵犯、淋巴结清扫数、BMI<18.5 kg/m2是远期生存的影响因素(P<0.05)。多因素分析显示:糖尿病、肿瘤直径>5 cm、pT3-4期、pN2-3期、淋巴结清扫数<16枚、BMI<18.5 kg/m2是影响胃癌患者远期生存的独立危险因素(P<0.05)。结论:低BMI患者术后5年生存率更低,高BMI患者术后5年生存率与正常BMI患者未见统计学差异;低BMI是影响胃癌患者远期生存的独立危险因素。Objective To analyze the relationship between preoperative body mass index(BMI)and long-term survival in patients with resectable gastric cancer.Methods The clinical data of 389 patients undergoing radical gastrectomy from January 2015 to May 2017 were retrospectively analyzed and divided into three groups according to BMI criteria,including 44 cases in the low BMI group,199 cases in the normal group and 146 cases in the high BMI group.The relationship between preoperative BMI and postoperative longterm survival of patients with gastric cancer was analyzed.SPSS 22.0 was used for data analysis,and the count data were compared byχ^(2)test.The measurement data were represented by(^(-)x±s),One-way ANOVA of variance was performed for multi-group comparison,and LSD test was used for pairwise comparison between groups.COX proportional risk model was used to analyze the factors affecting long-term survival.P<0.05 was considered statistically significant.Results There were significant differences in gender,diabetes mellitus,number of lymph node dissection and postoperative complications among the three groups(P<0.05).The 5-year overall survival rate of the low BMI group was significantly lower than that of the normal group and the high BMI group(44.7%vs.77.4%,44.7%vs.81.5%),and the difference was statistically significant(P<0.05).There was no significant difference(P>0.05).Univariate COX regression analysis showed that age,diabetes mellitus,tumor location,tumor diameter,degree of differentiation,pN stage,pT stage,vascular thrombolus,nerve invasion,number of lymph node dissection,BMI<18.5 kg/m2 were the influential factors for long-term survival of patients with gastric cancer(P<0.05).Multivariate analysis showed that diabetes mellitus,tumor diameter>5 cm,pT3-4 stage,pN2-3 stage,number of lymph nodes dissected<16,BMI<18.5 kg/m2 were independent risk factors for long-term survival of patients with gastric cancer(P<0.05).Conclusions The 5-year survival rate of patients with low BMI was lower,and there was no statistical di

关 键 词：胃肿瘤 胃切除术 身体质量指数 腹腔镜 手术后并发症 远期生存 

分 类 号：R735.2[医药卫生—肿瘤]