老年结肠癌患者术前老年营养风险指数评分对预后的预测效果分析  

Predictive value of preoperative geriatric nutritional risk index score on prognosis in elderly patients with colon cancer

作　　者：王凤侠 颜婕 崔莹[1] 李丽[1] Wang Fengxia;Yan Jie;Cui Ying;Li Li(Operating Room,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China)

机构地区：[1]新疆医科大学第一附属医院手术室,新疆乌鲁木齐830054

出　　处：《肿瘤综合治疗电子杂志》2025年第1期108-113,共6页Journal of Multidisciplinary Cancer Management(Electronic Version)

基　　金：新疆维吾尔自治区卫生与健康适宜技术推广项目(SYTG-Y202321)。

摘　　要：目的探讨老年结肠癌患者术前老年营养风险指数(geriatricnutritionalriskindex,GNRI)评分对预后的预测效果。方法回顾性分析2018年1月至2021年1月新疆医科大学第一附属医院收治的83例行根治性手术治疗的老年结肠癌患者的临床资料,比较不同临床病理特征患者的术前GNRI评分,采用单因素和多因素Cox回归分析探讨老年结肠癌患者预后的独立影响因素。结果83例患者的平均GNRI评分为(93.98±8.03)分,其中17例(20.5%)患者的GNRI评分>98分,视为无营养不良风险;66例(79.5%)患者的GNRI评分≤98分,视为存在营养不良风险,其中轻度、中度、重度营养不良风险发生率分别为39.8%(33/83)、22.9%(19/83)、16.9%(14/83)。年龄>75岁、有糖尿病、分化程度为低分化、T分期为T3~4期、有淋巴结转移、有神经侵犯、手术时间>2.5 h、术中出血量>200 ml患者的GNRI评分均分别显著低于年龄≤75岁、无糖尿病、分化程度为中高分化、T分期为T1~2期、无淋巴结转移、无神经侵犯、手术时间≤2.5 h、术中出血量≤200 ml(均P<0.05)。83例患者术后有10例患者存在并发症,包括5例切口愈合不良,3例肺部感染,2例吻合口瘘,这些患者予对症处理后均痊愈出院。存在并发症患者的GNRI评分分别与无并发症患者比较差异无统计意义(均P>0.05)。全部患者术后3年的无瘤生存率和总生存(overallsurvival,OS)率分别为71.1%和80.7%。中重度营养不良风险患者术后3年的无瘤生存率、OS率均分别显著低于无或轻度营养不良风险患者(均P<0.05)。多因素Cox比例风险回归模型分析显示,T分期为T3~4期、有淋巴结转移、有中重度营养不良风险均是导致老年结肠癌患者预后不良的独立危险因素(均P<0.05)。结论多数老年结肠癌患者术前存在营养不良的风险,低GNRI评分是术后远期预后不良的独立危险因素。Objective To investigate the predictive effect of preoperative geriatric nutritional risk index(GNRI)score on prognosis in elderly patients with colon cancer.Method The clinical data of 83 elderly patients with colon cancer who underwent radical surgery in The First Affiliated Hospital of Xinjiang Medical University from January 2018 to January 2021 were retrospectively analyzed.The preoperative GNRI scores of patients with different clinicopathological features were compared.Univariate and multivariate Cox regression analysis was used to explore the independent influencing factors of prognosis in elderly patients with colon cancer.Result The average GNRI score of 83 patients was(93.98±8.03)scores,of which 17(20.5%)patients had a GNRI score of>98 scores,which was considered as no risk of malnutrition;the GNRI score of 66 patients(79.5%)was≤98 scores,which was considered to be at risk of malnutrition.The incidence of mild,moderate and severe malnutrition risk was 39.8%(33/83),22.9%(19/83)and 16.9%(14/83),respectively.The GNRI scores of patients with age>75 years old,history of diabetes mellitus,low differentiation,T stage of T3-4,lymph node metastasis,nerve invasion,operation time>2.5 hours,and intraoperative blood loss>200 ml were significantly lower than those of patients with age≤75 years old,no history of diabetes mellitus,moderate to high differentiation,T stage of T1-2,no lymph node metastasis,no nerve invasion,operation time≤2.5 hours,and intraoperative blood loss≤200 ml(all P<0.05).Among the 83 patients,10 patients had complications after operation,including 5 cases of poor wound healing,3 cases of pulmonary infection and 2 cases of anastomotic leakage.These patients were cured and discharged after symptomatic treatment.There were no significant differences in GNRI score between patients with complications and patients without complications(all P>0.05).The 3-year disease-free survival rate and overall survival(OS)rate were 71.1%and 80.7%,respectively.The 3-year disease-free survival rate and OS r

关 键 词：结肠癌 老年营养风险指数 预后 预测 

分 类 号：R73[医药卫生—肿瘤]