Ding Ping'an, Guo Honghai, Yang Peigang, Sun Chenyu, Tian Yuan, Liu Yang, Li Yong, Zhao Qun
The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, United States.
Front Nutr. 2021 Oct 28;8:743475. doi: 10.3389/fnut.2021.743475. eCollection 2021.
Currently, the incidence of gastrointestinal stromal tumors (GIST) is increasing rapidly worldwide. Malnutrition may increase the risk of perioperative complications and affect the prognosis of patients. However, previous studies on the nutritional status of GIST patients and its impact on prognosis are limited. Therefore, this study aims to explore the incidence of malnutrition in newly diagnosed GIST patients, the proportion of participants in need of nutritional intervention, and the relationship between nutritional status and overall survival (OS). We retrospectively analyzed the clinical data of GIST patients treated in our hospital from January 2014 to January 2018. Nutritional Risk Screening 2002 (NRS2002) and Patient-Generated Subjective Global Assessment (PG-SGA) were used to assess the nutritional status of all patients. This study was to investigate the clinical significance of PG-SGA by analyzing the relationship between PG-SGA score and OS. A total of 1,268 newly diagnosed GIST patients were included in this study, of which 77.76% were at risk of malnutrition (NRS2002 score ≥ 3), and the incidence of malnutrition was 10.09% (PG-SGA score ≥ 4). Meanwhile, we found 2.29% of the patients required urgent nutritional support (PG-SGA score ≥ 9). Multivariate analysis showed that age ( = 0.013), BMI ( = 0.001), weight loss ( = 0.001), anemia ( = 0.005), pre-albumin ( = 0.010), albumin ( = 0.002), tumor location ( = 0.001), tumor size ( = 0.002), and NIH classification ( = 0.001) were risk factors for nutritional status. The prognosis was significantly in GIST patients with different PG-SGA score at admission ( < 0.05). This study suggested that malnutrition is common in newly diagnosed GIST patients, and the higher the PG-SGA score, the worse the clinical outcome.
目前,胃肠道间质瘤(GIST)的发病率在全球范围内正迅速上升。营养不良可能会增加围手术期并发症的风险并影响患者的预后。然而,先前关于GIST患者营养状况及其对预后影响的研究有限。因此,本研究旨在探讨新诊断的GIST患者中营养不良的发生率、需要营养干预的参与者比例以及营养状况与总生存期(OS)之间的关系。我们回顾性分析了2014年1月至2018年1月在我院接受治疗的GIST患者的临床资料。采用营养风险筛查2002(NRS2002)和患者主观整体评定法(PG-SGA)评估所有患者的营养状况。本研究通过分析PG-SGA评分与OS之间的关系来探讨PG-SGA的临床意义。本研究共纳入1268例新诊断的GIST患者,其中77.76%存在营养不良风险(NRS2002评分≥3),营养不良发生率为10.09%(PG-SGA评分≥4)。同时,我们发现2.29%的患者需要紧急营养支持(PG-SGA评分≥9)。多因素分析显示,年龄(=0.013)、BMI(=0.001)、体重减轻(=0.001)、贫血(=0.005)、前白蛋白(=0.010)、白蛋白(=0.002)、肿瘤位置(=0.001)、肿瘤大小(=0.002)和美国国立卫生研究院(NIH)分级(=0.001)是营养状况的危险因素。入院时不同PG-SGA评分的GIST患者预后差异有统计学意义(<0.05)。本研究表明,新诊断的GIST患者中营养不良很常见,PG-SGA评分越高,临床结局越差。