Department of Clinical Korean Medicine, Graduate School, Kyung Hee University , Dongdaemun-gu , Republic of Korea.
Department of Medical Oncology & Hematology, College of Medicine, Kyung Hee University , Seoul , Republic of Korea.
Nutr Cancer. 2019;71(7):1108-1117. doi: 10.1080/01635581.2019.1598564. Epub 2019 Apr 22.
Medical records of patients with advanced non-small cell lung cancer (NSCLC) were retrospectively reviewed to examine the prognostic impact of nutritional status on survival. Age, sex, body mass index (BMI), Eastern Cooperative Oncology Group Performance Status (ECOG-PS), histologic tumor type, pulmonary comorbidities, white blood cell (WBC) count, C-reactive protein (CRP) level, and prognostic nutritional index (PNI) were assessed. Overall survival was calculated using Kaplan-Meier analysis and compared using log-rank testing. Univariate and multivariate Cox regression model analyses were used to evaluate prognostic impact. Of the 183 enrolled patients, 166 had stage IV NSCLC; 70 had ECOG-PS scores of 2; and 129 had undergone prior anticancer therapy. Age ≥ 65 years, male sex, smoking, BMI < 21 kg/m, ECOG-PS score of 2, WBC count > 11,000 cells/μL, CRP level > 1.0 mg/dL, and PNI ≤46.1 were associated with poor overall survival. Multivariate analysis revealed that BMI ≥ 21 kg/m (hazard ratio [HR], 0.64) and PNI > 46.1 (HR, 0.65) were associated with prolonged survival, while age ≥ 65 years (HR, 1.48) and CRP level > 1.0 mg/dL (HR, 1.82) were associated with poor survival. In conclusion, BMI and PNI, as indicators of nutritional status, were significant independent prognostic factors of survival.
回顾性分析了晚期非小细胞肺癌（NSCLC）患者的病历，以研究营养状况对生存预后的影响。评估了年龄、性别、体重指数（BMI）、东部肿瘤协作组体能状态（ECOG-PS）评分、组织学肿瘤类型、肺部合并症、白细胞（WBC）计数、C 反应蛋白（CRP）水平和预后营养指数（PNI）。采用 Kaplan-Meier 分析计算总生存期，并采用对数秩检验比较。采用单因素和多因素 Cox 回归模型分析评估预后影响。在 183 名入组患者中，166 名患有 IV 期 NSCLC；70 名 ECOG-PS 评分为 2；129 名患者接受了既往抗癌治疗。年龄≥65 岁、男性、吸烟、BMI＜21kg/m、ECOG-PS 评分为 2、WBC 计数＞11,000 细胞/μL、CRP 水平＞1.0mg/dL 和 PNI≤46.1 与总生存期不良相关。多因素分析显示，BMI≥21kg/m（危险比 [HR]，0.64）和 PNI＞46.1（HR，0.65）与生存延长相关，而年龄≥65 岁（HR，1.48）和 CRP 水平＞1.0mg/dL（HR，1.82）与生存不良相关。总之，BMI 和 PNI 作为营养状况的指标，是生存的独立预后因素。
