Xu Li-Bin, Mei Ting-Ting, Cai Yi-Qi, Chen Wen-Jing, Zheng Si-Xin, Wang Liang, Chen Xiao-Dong, Huang Yun-Shi
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
Department of Gastrointestinal Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Oncol. 2022 Mar 3;12:851091. doi: 10.3389/fonc.2022.851091. eCollection 2022.
Malnutrition is recognized as a risk factor for poor outcome in patients with gastric cancer (GC). In 2018, the Global Leadership Initiative on Malnutrition (GLIM) published standardized criteria for the diagnosis of malnutrition. Our aim was to investigate whether any of the components of the GLIM diagnostic criteria were related to worse clinical outcomes in patients with GC.
This study analyzed patients with GC who underwent radical gastrectomy in our hospital between 2014 and 2019. A preoperative nutritional assessment was performed for each patient. Matching was based on the presence of three GLIM components: high weight loss (WL), low body mass index (BMI), and low skeletal muscle index (SMI).
The analysis included 1,188 patients, including 241 (20.3%) with high WL, 156 (13.1%) with low BMI, and 355 (29.9%) with low SMI. Before matching, patients who met the GLIM component criteria were mostly associated with older age, low nutritional reserves, and late tumor progression. After matching, the clinical characteristics of the three cohorts were balanced. In the matched queue, the survival prognosis of the high WL group was worse than that of the non-WL group, and the postoperative complication rate was higher in the low SMI group than in the normal SMI group (P <0.05). In addition, the clinical outcomes in the low and normal BMI groups were similar (P >0.05).
Of the GLIM criteria, high WL and low SMI may be associated with poor clinical outcomes in patients with GC, while a low BMI may not be associated with outcome.
营养不良被认为是胃癌（GC）患者预后不良的一个危险因素。2018年，全球营养不良领导倡议组织（GLIM）发布了营养不良诊断的标准化标准。我们的目的是调查GLIM诊断标准的任何组成部分是否与GC患者更差的临床结局相关。
本研究分析了2014年至2019年在我院接受根治性胃切除术的GC患者。对每位患者进行术前营养评估。匹配基于GLIM的三个组成部分：高体重减轻（WL）、低体重指数（BMI）和低骨骼肌指数（SMI）。
分析纳入1188例患者，其中高WL患者241例（20.3%），低BMI患者156例（13.1%），低SMI患者355例（29.9%）。在匹配前，符合GLIM组成部分标准的患者大多与年龄较大、营养储备低和肿瘤进展较晚有关。匹配后，三组队列的临床特征得到平衡。在匹配队列中，高WL组的生存预后比非WL组差，低SMI组的术后并发症发生率高于正常SMI组（P<0.05）。此外，低BMI组和正常BMI组的临床结局相似（P>0.05）。
在GLIM标准中，高WL和低SMI可能与GC患者不良的临床结局相关，而低BMI可能与结局无关。
