Department of Nutrition, Chang Gung Memorial Hospital, Keelung, Taiwan.
Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan.
Nutr Cancer. 2021;73(7):1130-1137. doi: 10.1080/01635581.2020.1792950. Epub 2020 Jul 15.
Various malnutrition and inflammation criteria were associated with prognosis of esophageal squamous cell carcinoma (ESCC) patients. Nonetheless, the interplay of clinicopathological features, malnutrition, and inflammation criteria with overall survival in ESCC patients remains unclear.
We retrospectively reviewed medical records of 205 patients diagnosed with ESCC between 2007 and 2012, and evaluated the status of participant malnutrition and inflammation, including body mass index < 18.5 kg/m, body weight loss > 5.0%, serum albumin level < 3.5 g/dl, neutrophil-to-lymphocyte ratio > 3.5, platelet-to-lymphocyte ratio > 20, prognostic nutrition index < 40, blood total lymphocyte count < 1600 cells/mm, and grades of body mass index-adjusted body weight loss (combined BMI-BWL). We assessed the association of clinicopathological features, nutritional status, and inflammation condition with overall survival using univariate and multivariate Cox regression analyses.
The mean overall survival of ESCC patients was 28.8 mo,. The multivariate logistic regression model after adjustment for clinicopathological variables, malnutrition status, inflammation condition, and co-morbid status found that tumor stage and grades of combined BMI-BML served as equally important prognostic factors for overall survival.
Advanced tumor stage and high grades of combined BMI-BWL were independent prognostic factors for overall survival in ESCC patients.
各种营养不良和炎症标准与食管鳞状细胞癌(ESCC)患者的预后相关。然而,ESCC 患者的临床病理特征、营养不良和炎症标准与总生存之间的相互作用仍不清楚。
我们回顾性分析了 2007 年至 2012 年间诊断为 ESCC 的 205 例患者的病历,并评估了患者营养不良和炎症的状况,包括体重指数<18.5kg/m²、体重减轻>5.0%、血清白蛋白水平<3.5g/dl、中性粒细胞与淋巴细胞比值>3.5、血小板与淋巴细胞比值>20、预后营养指数<40、全血淋巴细胞计数<1600 个细胞/mm³以及体重指数调整后的体重减轻等级(合并 BMI-BWL)。我们使用单因素和多因素 Cox 回归分析评估了临床病理特征、营养状况和炎症状态与总生存的相关性。
ESCC 患者的平均总生存时间为 28.8 个月。在调整了临床病理变量、营养不良状态、炎症状态和合并症状态后,多因素逻辑回归模型发现肿瘤分期和合并 BMI-BWL 的等级是总生存的同等重要的预后因素。
晚期肿瘤分期和合并 BMI-BWL 等级高是 ESCC 患者总生存的独立预后因素。