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三种营养工具在结直肠癌患者中的表现各不相同:一项回顾性分析。

The performance of three nutritional tools varied in colorectal cancer patients: a retrospective analysis.

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China.

Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.

出版信息

J Clin Epidemiol. 2022 Sep;149:12-22. doi: 10.1016/j.jclinepi.2022.04.026. Epub 2022 May 7.

Abstract

BACKGROUND AND OBJECTIVE

Nutritional screening tools should be sensitive, simple, and easy to use. Differing opinions among clinicians concern the simplicity of the three tools-the Global Leadership Initiative on Malnutrition (GLIM) criteria, Nutritional Risk Screening 2002 (NRS-2002), and Patient-Generated Subjective Global Assessment (PG-SGA). For each tool, we estimated prediction of overall survival (OS) in tumor staging, sensitivity, and specificity. The NRS-2002 is favored by clinicians because it is simple to use. We compared its sensitivity and specificity with the GLIM and PG-SGA.

STUDY DESIGN AND SETTING

This is an analysis of data from 1,358 adult colorectal cancer patients recruited in a multicenter from July 2013 to July 2018.

RESULTS

In Kaplan-Meier models, each tool was found to be significantly predictive of OS: NRS-2002 (1.28), GLIM (1.49), and PG-SGA (1.42). Use of any tool improved prediction of survival at tumor staging. NRS-2002 has superior specificity (0.90) to diagnose patients without nutritional deficits (GLIM = 0.62 and PG-SGA = 0.82).

CONCLUSION

This study provides evidence for the superiority of NRS-2002 to accurately identify colorectal cancer patients without nutritional limitations. Compared with the complexity of the other tools, NRS-2002 is the simplest tool to use in routine nutritional screening in busy clinical practice.

摘要

背景与目的

营养筛选工具应该具有敏感性、简单性和易用性。临床医生对三种工具(全球营养不良领导倡议(GLIM)标准、营养风险筛查 2002(NRS-2002)和患者生成的主观整体评估(PG-SGA))的简单性存在不同意见。对于每种工具,我们估计了其在肿瘤分期中的总体生存(OS)预测、敏感性和特异性。NRS-2002 因其易于使用而受到临床医生的青睐。我们将其敏感性和特异性与 GLIM 和 PG-SGA 进行了比较。

研究设计与设置

这是对 2013 年 7 月至 2018 年 7 月期间在多中心招募的 1358 例成年结直肠癌患者数据的分析。

结果

在 Kaplan-Meier 模型中,每个工具都被发现对 OS 有显著的预测作用:NRS-2002(1.28)、GLIM(1.49)和 PG-SGA(1.42)。使用任何工具都可以提高肿瘤分期时对生存的预测。NRS-2002 在诊断无营养缺陷的患者时具有更高的特异性(0.90)(GLIM=0.62 和 PG-SGA=0.82)。

结论

本研究为 NRS-2002 优于准确识别无营养限制的结直肠癌患者提供了证据。与其他工具的复杂性相比,NRS-2002 是在繁忙的临床实践中进行常规营养筛选时最简单的工具。

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