验证 NUTRISCORE 在中国癌症患者营养筛查中的功效。
Validation of the efficacy of the NUTRISCORE for the nutritional screening of cancer patients in China.
机构信息
Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, #1 Shuai Fu Yuan, Beijing, 100730, Dongcheng District, China.
出版信息
BMC Cancer. 2022 Jan 6;22(1):43. doi: 10.1186/s12885-021-09135-2.
BACKGROUND
Malnutrition is common in cancer patients. The NUTRISCORE is a newly developed cancer-specific nutritional screening tool and was validated by comparison with the Patient-Generated Subjective Global Assessment (PG-SGA) and Malnutrition Screening Tool (MST) in Spain. We aimed to evaluate the performance of the NUTRISCORE, MST, and PG-SGA in estimating the risk of malnutrition in Chinese cancer patients.
METHODS
Data from an open parallel and multicenter cross-sectional study in 29 clinical teaching hospitals in 14 Chinese cities were used. Cancer patients were assessed for malnutrition using the PG-SGA, NUTRISCORE, and MST. The sensitivity, specificity, and areas under the receiver operating characteristic curve were estimated for the NUTRISCORE and MST using the PG-SGA as a reference.
RESULTS
A total of 1000 cancer patients were included. The mean age was 55.9 (19 to 92 years), and 47.5% were male. Of these patients, 450 (45.0%) had PG-SGA B and C, 29 (2.9%) had a NUTRISCORE ≥5, and 367 (36.7%) had an MST ≥ 2. Using the PG-SGA as a reference, the sensitivity, specificity, and area under the curve values of the NUTRISCORE were found to be 6.2, 99.8%, and 0.53, respectively. The sensitivity, specificity, and area under the curve values of the MST were 50.9, 74.9%, and 0.63, respectively. The kappa index between the NUTRISCORE and PG-SGA was 0.066, and that between the MST and PG-SGA was 0.262 (P < 0.05).
CONCLUSIONS
The NUTRISCORE had an extremely low sensitivity in cancer patients in China compared with the MST when the PG-SGA was used as a reference.
背景
营养不良在癌症患者中很常见。NUTRISCORE 是一种新开发的癌症特异性营养筛查工具，已在西班牙通过与患者主观整体评估（PG-SGA）和营养不良筛查工具（MST）进行比较得到验证。我们旨在评估 NUTRISCORE、MST 和 PG-SGA 在评估中国癌症患者营养不良风险中的表现。
方法
使用来自中国 14 个城市的 29 家临床教学医院的一项开放平行多中心横断面研究的数据。使用 PG-SGA、NUTRISCORE 和 MST 对癌症患者进行营养不良评估。使用 PG-SGA 作为参考，估计 NUTRISCORE 和 MST 的敏感性、特异性和受试者工作特征曲线下面积。
结果
共纳入 1000 例癌症患者。平均年龄为 55.9（19 至 92 岁），47.5%为男性。其中，450 例（45.0%）患者 PG-SGA 为 B 和 C，29 例（2.9%）患者 NUTRISCORE≥5，367 例（36.7%）患者 MST≥2。以 PG-SGA 为参考，NUTRISCORE 的敏感性、特异性和曲线下面积值分别为 6.2%、99.8%和 0.53。MST 的敏感性、特异性和曲线下面积值分别为 50.9%、74.9%和 0.63。NUTRISCORE 与 PG-SGA 之间的 Kappa 指数为 0.066，MST 与 PG-SGA 之间的 Kappa 指数为 0.262（P<0.05）。
结论
与 MST 相比，以 PG-SGA 为参考时，NUTRISCORE 在我国癌症患者中的敏感性极低。
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