控制营养状况评分可预测胃癌患者的个体化生存。
Controlling Nutritional Status score predict the individualized survival of patients with gastric cancer.
机构信息
Oncology Department, Peking University, First Hospital, Beijing, China.
Pathology Department, Peking University, First Hospital, Beijing, China.
出版信息
Asia Pac J Clin Nutr. 2021;30(1):51-59. doi: 10.6133/apjcn.202103_30(1).0007.
BACKGROUND AND OBJECTIVES
The present study aimed to determine the correlation between Controlling Nutritional Status (CONUT) score and prognosis in gastric cancer patients undergoing total gastrectomy.
METHODS AND STUDY DESIGN
The clinical data of 245 gastric cancer patients who underwent total gastrectomy in Peking University, First Hospital between January1st 2005 and December 30th 2015 were retrospectively collected. According to the CONUT level, they were divided into high CONUT (>3) group and low CONUT (≤3) group. The relationship between CONUT and the disease-free survival (DFS) and overall survival (OS) were analyzed by statistical analysis.
RESULTS
The results showed that the optimal cutoff value for CONUT to predict the 5-year survival was 3 and CONUT had a higher area under the ROC curve (AUC) for 5-year disease free survival (DFS) and overall survival (OS) prediction. Additionally, when age was considered as a stratified factor, univariate analyses demonstrated that high CONUT correlated with shorter DFS in non-elderly (<65) patients and shorter DFS and OS in elderly (≥65) patients.
CONCLUSIONS
High CONUT was significantly correlated with older age, advanced TNM-stage, higher Ki-67 and pathological subtype. Patients with high pre-operative high CONUT levels should be given more observation and constant follow-up after surgery.
背景与目的
本研究旨在探讨控制营养状况（CONUT）评分与行全胃切除术的胃癌患者预后的相关性。
方法和研究设计
回顾性收集了 2005 年 1 月 1 日至 2015 年 12 月 30 日期间在北京大学第一医院行全胃切除术的 245 例胃癌患者的临床资料。根据 CONUT 水平，将患者分为高 CONUT（>3）组和低 CONUT（≤3）组。通过统计学分析，探讨 CONUT 与无病生存（DFS）和总生存（OS）的关系。
结果
结果表明，CONUT 预测 5 年生存率的最佳截断值为 3，且 CONUT 对 5 年无病生存（DFS）和总生存（OS）的预测具有更高的 ROC 曲线下面积（AUC）。此外，当考虑年龄为分层因素时，单因素分析表明，高 CONUT 与非老年（<65 岁）患者的较短 DFS 以及老年（≥65 岁）患者的较短 DFS 和 OS 相关。
结论
高 CONUT 与年龄较大、TNM 分期较晚、Ki-67 较高和病理亚型有关。术前高 CONUT 水平的患者术后应给予更多的观察和持续随访。
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