Department of Cardiothoracic Surgery, Cangzhou Central Hospital, Cangzhou, China.
Nursing Department, Cangzhou Central Hospital, Cangzhou, China.
Horm Metab Res. 2022 Sep;54(9):604-612. doi: 10.1055/a-1903-1943. Epub 2022 Sep 7.
Geriatric nutritional risk index (GNRI), a newly developed indicator of nutritional status retrieved by serum albumin concentration and ideal body weight, has been suggested as a prognostic factor for various malignancies. The aim of the study was to summarize the prognostic role of GNRI for patients with non-small cell lung cancer (NSCLC) in a meta-analysis. Cohort studies evaluating the relationship between GNRI at baseline and survival OF NSCLC were retrieved by search of PubMed, Embase, and Web of Science databases from inception to January 12, 2022. A conservative random-effect model incorporating the possible influence of between-study heterogeneity was used to pool the results. Eleven cohorts including 2865 patients with NSCLC were included. Compared to those with higher GNRI, NSCLC patients with lower GNRI were associated with poorer overall survival [OS, hazard ratio (HR): 2.39, 95% CI: 1.97-2.91, p<0.001; I2=29%), progression-free survival (HR: 1.94, 95% CI: 1.52-2.47, p<0.001; I2=29%), and cancer-specific survival (HR: 2.59, 95% CI: 1.55-4.35, p<0.001; I2=0%). Subgroup analyses showed that the significant association between lower GNRI and worse OS in patients with NSCLC was not affected by study characteristics including study location, design, cancer stage, treatment, or follow-up durations (p for subgroup effects all<0.001). In conclusion, a lower GNRI in patients with NSCLC may be a predictor of poor survival. Nutritional status indicated by GNRI may be important for the prognostic prediction of patients with NSCLC.
老年营养风险指数（GNRI）是一种新开发的营养状况指标，通过血清白蛋白浓度和理想体重计算得出，已被认为是多种恶性肿瘤的预后因素。本研究旨在通过荟萃分析总结 GNRI 对非小细胞肺癌（NSCLC）患者预后的作用。通过检索 PubMed、Embase 和 Web of Science 数据库，从建库至 2022 年 1 月 12 日，纳入评估基线时 GNRI 与 NSCLC 患者生存关系的队列研究。采用包含研究间异质性可能影响的保守随机效应模型对结果进行汇总。共纳入 11 项包含 2865 例 NSCLC 患者的队列研究。与 GNRI 较高的患者相比，GNRI 较低的 NSCLC 患者总生存期（OS，风险比 [HR]：2.39，95%CI：1.97-2.91，p<0.001；I2=29%）、无进展生存期（HR：1.94，95%CI：1.52-2.47，p<0.001；I2=29%）和癌症特异性生存期（HR：2.59，95%CI：1.55-4.35，p<0.001；I2=0%）更差。亚组分析显示，GNRI 较低与 NSCLC 患者 OS 较差之间的显著相关性不受研究特征（包括研究地点、设计、癌症分期、治疗和随访时间）的影响（亚组效应 p 值均<0.001）。总之，NSCLC 患者 GNRI 较低可能是生存不良的预测因素。GNRI 所指示的营养状况可能对 NSCLC 患者的预后预测具有重要意义。
