营养-炎症指标在乳腺癌患者中的预后价值。
Prognostic Power of Nutrition-Inflammation Indicators in Patients With Breast Cancer.
机构信息
Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China; Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.
Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China; Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China; Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.
出版信息
Clin Breast Cancer. 2023 Jul;23(5):e312-e321. doi: 10.1016/j.clbc.2023.04.009. Epub 2023 May 5.
BACKGROUND
Inflammation and nutritional statuses are closely related to the survival of patients with cancer. Breast cancer is the one with low level of inflammation and low risk of malnutrition. Does inflammation burden and nutrition status affect the prognosis of patients with breast cancer?
METHODS
Totally 1158 patients with breast cancer from Nutrition Status and its Clinical Outcome of Common Cancers study were included, 15 nutrition-inflammation indicators (NIIs) from literatures were adopted in this study. Area under the curve and C-index were used to compare the predictive value of 15 NIIs in overall patients and subgroup in different menstrual statuses.
RESULTS
Nutrition status indicators prognostic nutritional index, controlling nutritional status score, glucose-to-lymphocyte ratio among 15 NIIs were found to be significantly associated with prognosis of breast cancer, and remained stable in patients in different menstrual statuses. The C-index of inflammation indicators lymphocyte-to-C-reactive protein ratio, lymphocyte-C-reactive protein ratio score, and C-reaction protein (CRP) increased with age, but the predictive value of 3 inflammation indicators did not exceed the value of nutritional indicators throughout the whole life of patients with breast cancer.
CONCLUSIONS
Prognostic nutritional index, controlling nutritional status score, glucose-to-lymphocyte ratio had better predictive value for the survival of patients with breast cancer. Nutritional indicators surpassed inflammation indicators in prognostic ability for patients in different menstrual statuses. These results provide an important insight for the care of patients with breast cancer.
背景
炎症和营养状况与癌症患者的生存密切相关。乳腺癌的炎症水平低,营养不良风险低。炎症负担和营养状况是否会影响乳腺癌患者的预后?
方法
本研究共纳入了来自营养状况及其常见癌症临床结局研究的 1158 例乳腺癌患者,采用了 15 项营养-炎症指标(NIIs)。采用曲线下面积和 C 指数比较了 15 项 NIIs 在总体患者和不同月经状态亚组中的预测价值。
结果
在 15 项 NIIs 中,营养状况指标预后营养指数、控制营养状况评分、葡萄糖与淋巴细胞比值与乳腺癌的预后显著相关,在不同月经状态的患者中保持稳定。炎症指标淋巴细胞与 C 反应蛋白比值、淋巴细胞-C 反应蛋白比值评分和 C 反应蛋白的 C 指数随年龄增加而增加,但在乳腺癌患者的整个生命周期内,3 项炎症指标的预测价值并未超过营养指标。
结论
预后营养指数、控制营养状况评分、葡萄糖与淋巴细胞比值对乳腺癌患者的生存具有更好的预测价值。在不同月经状态的患者中,营养指标在预测能力上优于炎症指标。这些结果为乳腺癌患者的护理提供了重要的见解。