预后营养指数在预测晚期小细胞肺癌患者预后中的临床意义  

Clinical significance of prognostic nutritional index in predicting prognosis of patients with advanced small cell lung cancer

作　　者：马千惠 潘瑞丽 关玉霞[2] 郭爱敏[3] MAQianhui;PAN Ruili;GUAN Yuxia;GUO Aimin(Department of Respiratory and Critical Care Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Nursing,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;School of Nursing,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医院呼吸与危重症医学科,北京100730 [2]中国医学科学院北京协和医院护理部,北京100730 [3]中国医学科学院北京协和医学院护理学院,北京100144

出　　处：《癌症进展》2024年第1期25-29,43,共6页Oncology Progress

基　　金：北京协和医院护理科研课题(XHHLKY202103)。

摘　　要：目的探讨预后营养指数(PNI)对接受规律治疗的晚期小细胞肺癌(SCLC)患者预后的影响。方法选取116例接受规律治疗的晚期SCLC患者,收集所有患者的临床资料,比较不同临床特征晚期SCLC患者的中位总生存期(OS)。抗肿瘤药物治疗前1周及治疗后3、6、9、12个月分别收集患者的营养相关指标,各时间节点数据应用对数-差分法进行处理后,分析各营养指标的变化情况。分析不同时间节点PNI对晚期SCLC患者预后的影响。结果不同体力状况评分、免疫治疗情况晚期SCLC患者的中位OS比较,差异均有统计学意义(P﹤0.05);患者体力状态评分越高,中位OS越短,接受免疫治疗患者的中位OS长于未接受免疫治疗的患者。在观察期内,患者的体重变化不明显;白细胞计数、淋巴细胞计数、白蛋白水平和PNI均在治疗3个月时下降至最低值,而后缓慢升高再下降;前白蛋白水平在接受治疗的6个月内呈上升趋势,治疗6个月时达到高峰,而后迅速下降,治疗12个月时下降至最低值。治疗前及治疗3个月时,根据PNI临界值对患者进行分组,低PNI组与高PNI组患者的中位OS比较,差异均无统计学意义(P﹥0.05)。治疗6、9、12个月时,根据PNI临界值对患者进行分组,低PNI组患者的中位OS均明显短于高PNI组,差异均有统计学意义(P﹤0.01)。结论晚期SCLC患者接受抗肿瘤药物治疗后早期营养状态改变不明显,对预后无明显影响,但治疗6个月时的营养状态可影响患者预后。提示临床医护人员应在治疗6个月时重点关注SCLC患者的营养问题,从而提高治疗效果,改善患者的生活质量。Objective To investigate the effect of prognostic nutritional index(PNI)on prognosis of patients with advanced small cell lung cancer(SCLC)receiving regular treatment.Method A total of 116 patients with advanced SCLC receiving regular treatment were selected,clinical data of all patients were collected,and the median overall survival(OS)of patients with advanced SCLC with different clinical characteristics were compared.Nutrition-related indexes of patients were collected 1 week before treatment with antitumor drugs and 3,6,9,and 12 months after treatment,respectively.Log-difference method was applied to the data at each time node to analyze the changes of nutritional indexes.The effect of PNI at different time nodes on the prognosis of patients with advanced SCLC were analyzed.Result There were significant differences in the median OS of advanced SCLC patients with different performance status scores and immunotherapy condition(P<0.05).The higher the performance status score,the shorter the median OS,and the median OS of patients receiving immunotherapy was longer than that of patients not receiving immunotherapy.During the observation period,the weight of the patients did not change significantly.White blood cell count,lymphocyte count,albumin level and PNI all decreased to the lowest value after 3 months of treatment,and then slowly increased and then decreased.The level of prealbumin increased within 6 months of treatment,reached a high peak at 6 months of treatment,and then rapidly decreased to the lowest value after 12 months of treatment.Before treatment and 3 months after treatment,the patients were grouped according to the PNI critical value,there were no significances in the median OS between the low PNI group and the high PNI group(P>0.05).After 6,9 and 12 months of treatment,the patients were grouped according to the PNI critical value,and the median OS in the low PNI group were shorter than those in the high PNI group,and the differ-ences were statistically significant(P<0.01).Conclusion After treatm

关 键 词：预后营养指数 小细胞肺癌 总生存期 

分 类 号：R734.2[医药卫生—肿瘤]