结直肠癌根治术前患者主观整体营养状况评分与近远期预后的相关性分析  

Correlation analysis between patient-generated subjective global assessment and short-term and long-term prognosis in patients with colorectal cancer undergoing radical surgery

作　　者：魏曼莉 董云生 魏金鑫 吴雪 Wei Manli;Dong Yunsheng;Wei Jinxin;Wu Xue(Department of Gastrointestinal Surgery,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,China;Department of General Surgery,General Surgery,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,China)

机构地区：[1]南京医科大学第四附属医院胃肠外科,南京210031 [2]南京医科大学第四附属医院普外科,南京210031

出　　处：《肿瘤综合治疗电子杂志》2023年第3期115-119,共5页Journal of Multidisciplinary Cancer Management(Electronic Version)

摘　　要：目的探讨结直肠癌根治术前患者主观整体营养状况评估(patient-generated subjective global assessment,PG-SGA)量表评分与近远期预后的相关性。方法选取2017年1月至2020年1月南京医科大学第四附属医院收治的106例结直肠癌根治术患者为研究对象。根据患者术前PG-SGA量表评分将其分为营养正常组(PG-SGA量表评分<4分,71例)与营养不良组(PG-SGA量表评分≥4分,35例),比较两组患者的临床资料和术后随访结果,通过多因素Cox回归分析探讨患者预后不良的独立危险因素。结果与营养正常组相比,营养不良组患者的体重指数更低(P<0.05),TNM分期Ⅲ期、低分化的比例更高(均P<0.05),肿瘤最大径更大(P<0.05),术后住院天数更长(P<0.05),术后并发症发生率更高(P<0.05)。全部患者术后1年无瘤生存率、总生存率分别为86.8%、90.6%,术后3年无瘤生存率、总生存率分别为76.4%、80.2%。与营养正常组相比,营养不良组患者术后3年无瘤生存率、总生存率均更低(均P<0.05)。多因素Cox回归分析结果表明,年龄升高、TNM分期Ⅲ期、PG-SGA量表评分≥4分均为结直肠癌根治术患者预后不良的独立危险因素(均P<0.05)。结论结直肠癌患者术前PG-SGA量表评分≥4分是预后不良的独立危险因素,PG-SGA量表有助于临床制订治疗和随访方案。Objective To analyze the correlation analysis between patient-generated subjective global assessment(PG-SGA)and short-term and long-term prognosis in patients with colorectal cancer underwent radical surgery.Method One hundred and six cases of colorectal cancer patients underwent radical surgery from January 2017 to January 2020 admitted in The Fourth Affiliated Hospital of Nanjing Medical University were divided into normal nutrition group(PG-SGA scale score<4 points,71 cases)and malnutrition group(PG-SGA scale score≥4 points,35 cases)based on the preoperative PG-SGA scale.The clinical data and postoperative follow-up results of the two groups were compared,and multivariate Cox regression analysis was performed to explore the independent risk factors of poor prognosis.Result Compared with normal nutrition group,patients in malnutrition group had lower body mass index(P<0.05),higher proportion of TNM stageⅢand low differentiation(all P<0.05),larger tumor diameter(P<0.05),longer postoperative hospital day(P<0.05),and higher incidence of postoperative complications(P<0.05).The 1-year postoperative tumor free survival rate and overall survival rate of all patients were 86.8%and 90.6%,respectively.The 3-year postoperative tumor free survival rate and overall survival rate were 76.4%and 80.2%,respectively.Compared with normal nutrition group,patients in malnutrition group had lower 3-year tumor free survival rate and overall survival rate(all P<0.05).Multivariate Cox regression analysis showed that age increase,TNM stageⅢand PG-SGA scale score≥4 points were the independent risk factors for poor prognosis(all P<0.05).Conclusion Preoperative PG-SGA scale score≥4 points in colorectal cancer patients is an independent risk factor for poor prognosis,and PG-SGA scale is helpful for clinical treatment and follow-up plan.

关 键 词：结直肠癌 患者主观整体营养状况评估 营养支持 预后 预测 

分 类 号：R735.34[医药卫生—肿瘤]