Zhao Haiming, Xu Li, Tang Peng, Guo Rui
Department of Gastroenterology, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
Front Oncol. 2022 Jun 30;12:906711. doi: 10.3389/fonc.2022.906711. eCollection 2022.
Geriatric nutritional risk index (GNRI) is an indicator of nutritional status derived by serum albumin level and ideal body weight, which has been proposed as a predictor of prognosis for elderly population with various clinical conditions. The objective of the meta-analysis was to comprehensively evaluate the association between baseline GNRI and survival of patients with colorectal cancer (CRC).
Cohort studies were identified by search of PubMed, Embase, and Web of Science databases from inception to January 05, 2022 according to the aim of the meta-analysis. A random-effect model incorporating the potential between-study heterogeneity was adopted to pool the results.
Nine studies including 3658 patients with CRC contributed to the meta-analysis. Results showed that CRC patients with lower GNRI at baseline had worse overall survival (OS, hazard ratio [HR] 2.39, 95% confidence interval [CI] 1.78-3.23, p<0.001; I 60%) and progression-free survival (PFS, HR 1.77, 95% CI 1.38-2.26, p<0.001; I 33%). The results were consistent in sensitivity analyses limited to elderly patients (HR for OS 2.25, p<0.001; HR for PFS 1.65, p=0.003). Subgroup analyses showed consistent results in patents with different cancer stages, and in studies with median follow-up < and ≥ 5 years (p for subgroup effects all < 0.05).
A lower GNRI at baseline may be independent associated with poor survival outcomes of patients with CRC. Evaluating the nutritional status using GNRI may be important for risk stratification of patients with CRC.
老年营养风险指数（GNRI）是一种通过血清白蛋白水平和理想体重得出的营养状况指标，已被提议作为各种临床状况老年人群预后的预测指标。本荟萃分析的目的是全面评估基线GNRI与结直肠癌（CRC）患者生存之间的关联。
根据荟萃分析的目的，通过检索PubMed、Embase和Web of Science数据库，从数据库建立至2022年1月5日，识别队列研究。采用纳入研究间潜在异质性的随机效应模型汇总结果。
9项研究共纳入3658例CRC患者，参与了本次荟萃分析。结果显示，基线GNRI较低的CRC患者总生存期（OS，风险比[HR] 2.39，95%置信区间[CI] 1.78 - 3.23，p<0.001；I² 60%）和无进展生存期（PFS，HR 1.77，95% CI 1.38 - 2.26，p<0.001；I² 33%）较差。在仅限于老年患者的敏感性分析中结果一致（OS的HR为2.25，p<0.001；PFS的HR为1.65，p = 0.003）。亚组分析显示，在不同癌症分期的患者以及中位随访时间<5年和≥5年的研究中结果一致（亚组效应的p值均<0.05）。
基线GNRI较低可能与CRC患者不良生存结局独立相关。使用GNRI评估营养状况可能对CRC患者的风险分层很重要。
