Zhu X S, Zhao Y, Ma F Y, Xuan L, Wu S K
Oncology Department, Peking University, First Hospital, Beijing 100031, China.
Pathology Department, Peking University, First Hospital, Beijing 100031, China.
Zhonghua Yi Xue Za Zhi. 2021 Feb 9;101(6):421-428. doi: 10.3760/cma.j.cn112137-20200513-01527.
To evaluate the effect of nutritional status on clinical and pathological data for stage Ⅰ-Ⅳ gastric cancer patients from the cancer survival investigation information. A database of 302 consecutive gastric cancer patients underwent radical gastrectomy was enrolled in this study. The clinical and pathological information of them were corrected and the relationship between the nutritional index and the patients survival time were analyzed by a Cox regression model. The clinical data analysis of 302 patients with gastric cancer who received total gastric resection indicated that the nutritional status was related to the stage of tumor patients, suggesting that the later the stage was, the more necessary the nutritional therapy intervention was. Univariate analysis showed that Ⅲ+Ⅳ of TNM staging (=4.417, 95%:2.483-6.351; =0.029), patient age of 65 and above (=2.217, 95%:0.522-3.912; =0.038), lymph node metastasis positive (=2.517, 95%:0.516-4.518; =0.036), poor tumor differentiation (=3.626, 95%:0.721-6.531; =0.021) and low PNI (=2.612, 95%: 0.712-4.512; =0.029) is an important risk factor for poor prognosis. In the multivariate analysis, Ⅲ+Ⅳ of TNM staging (=3.821, 95%:1.923-5.719; =0.014), patient age of 65 and above (=1.168, 95%:0.321-2.015; =0.036) and low PNI (=2.435, 95%1.024-3.846; =0.039) was independently correlated with poor survival time; When age was used as a stratification factor, the correlation between CONUT recurrence and survival in patients with gastric cancer ≥65 years old after total gastric resection was analyzed and compared. For disease-free survival, the CONUT high group (>3) was 25.2 months, while the CONUT low group (≤3) was 30.9 months, (χ=3.763,=0.029), showing a significant difference. For the overall survival, the CONUT high(>3) group was 30.3 months, compared with the CONUT low(≤3) group at 34.5 months, (χ=4.924,=0.042), and the difference was also statistically significant. High controlling nutritional status is an independent risk factor associated with poor gastric cancer survival and it is an independent risk factor in predicting overall survival (OS) in elderly (≥65) gastric cancer after radical gastrectomy.
为了从癌症生存调查信息中评估营养状况对Ⅰ-Ⅳ期胃癌患者临床和病理数据的影响。本研究纳入了302例连续接受根治性胃切除术的胃癌患者数据库。校正了他们的临床和病理信息，并通过Cox回归模型分析营养指标与患者生存时间之间的关系。对302例接受全胃切除术的胃癌患者的临床数据分析表明，营养状况与肿瘤患者分期相关，提示分期越晚，营养治疗干预越有必要。单因素分析显示，TNM分期Ⅲ+Ⅳ期（=4.417，95%：2.483 - 6.351；=0.029）、患者年龄65岁及以上（=2.217，95%：0.522 - 3.912；=0.038）、淋巴结转移阳性（=2.517，95%：0.516 - 4.518；=0.036）、肿瘤低分化（=3.626，95%：0.721 - 6.531；=0.021）和低预后营养指数（=2.612，95%：0.712 - 4.512；=0.029）是预后不良的重要危险因素。多因素分析中，TNM分期Ⅲ+Ⅳ期（=3.821，95%：1.923 - 5.719；=0.014）、患者年龄65岁及以上（=1.168，95%：0.321 - 2.015；=0.036）和低预后营养指数（=2.435，95% 1.024 - 3.846；=0.039）与生存时间差独立相关；以年龄作为分层因素，分析比较全胃切除术后≥65岁胃癌患者中控制营养状况（CONUT）与复发及生存的相关性。对于无病生存，CONUT高分组（>3）为25.2个月，而CONUT低分组（≤3）为30.9个月，（χ=3.763，=0.029），差异有统计学意义。对于总生存，CONUT高（>3）组为30.3个月，CONUT低（≤3）组为34.5个月，（χ=4.924，=0.042），差异也有统计学意义。高控制营养状况是与胃癌生存不良相关的独立危险因素，且是预测根治性胃切除术后老年（≥65岁）胃癌总生存（OS）的独立危险因素。
