Mao Yuantian, Liu Jinlu, Li Jiaming, Qiu Yue, Wang Zhen, Li Bopei, Liu Siyu, Tian Lei, Chen Junqiang
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi Zhuang Autonomous Region, China.
Front Oncol. 2023 May 24;13:1173532. doi: 10.3389/fonc.2023.1173532. eCollection 2023.
Recent studies have reported hypersensitive C-reactive protein (hs-CRP) linked to clinicopathological characteristics and nutritional status of the tumor, but its clinical significance in GC remains unclear. This study aimed to investigate the relationship between preoperative serum hs-CRP level and clinicopathological features and nutritional status in gastric cancer (GC) patients.
The clinical data of 628 GC patients who met the study criteria were analyzed retrospectively. The preoperative serum hs-CRP level was divided into two groups (<1 mg/L and ≥1 mg/L) to evaluate clinical indicators. Nutritional Risk Screening and nutritional assessment of GC patients were performed by the Nutritional Risk Screening 2002 (NRS2002) and the Patient-Generated Subjective Global Assessment (PG-SGA), respectively. The data were subjected to chi-square test, univariate and multivariate logistic regression analyses, respectively.
The analysis of 628 GC cases revealed that 338 patients (53.8%) were on malnutrition risk(NRS2002≥3 points), and 526(83.8%) had suspected/moderate to severe malnutrition(PG-SGA≥ 2 points). Preoperative serum hs-CRP level was significantly correlated with age, tumor maximum diameter (TMD), peripheral nerve invasion (PNI), lymph-vascular invasion (LVI), depth of tumor invasion (DTI), lymph node metastasis (LNM), pTNM stage, body weight loss (BWL), body mass index (BMI), NRS2002 score, PG-SGA grade, hemoglobin (HB), total protein (TP), albumin (ALB), prealbumin (PAB) and total lymphocyte count (TLC). Multivariate logistic regression analysis revealed that hs-CRP (OR=1.814, 95%CI=1.174-2.803; =0.007), age, ALB, BMI, BWL and TMD were independent risk factors for existing malnutritional risk in GC. Similarly, non-malnutrition and suspected/moderate to severe malnutrition groups presented that hs-CRP (OR=3.346, 95%CI=1.833-6.122; < 0.001), age, HB, ALB, BMI and BWL were independent risk factors for malnutrition in GC.
In addition to the generally used nutritional evaluation indicators such as age, ALB, BMI, and BWL, the hs-CRP level may be used as a nutritional screening and evaluation indicator for GC patients.
近期研究报道超敏C反应蛋白（hs-CRP）与肿瘤的临床病理特征及营养状况相关，但其在胃癌中的临床意义仍不明确。本研究旨在探讨胃癌（GC）患者术前血清hs-CRP水平与临床病理特征及营养状况之间的关系。
回顾性分析628例符合研究标准的GC患者的临床资料。将术前血清hs-CRP水平分为两组（<1mg/L和≥1mg/L）以评估临床指标。分别采用营养风险筛查2002（NRS2002）和患者主观整体评定法（PG-SGA）对GC患者进行营养风险筛查和营养评估。数据分别进行卡方检验、单因素和多因素逻辑回归分析。
对628例GC病例分析显示，338例患者（53.8%）存在营养不良风险（NRS2002≥3分），526例（83.8%）存在疑似/中度至重度营养不良（PG-SGA≥2分）。术前血清hs-CRP水平与年龄、肿瘤最大直径（TMD）、周围神经侵犯（PNI）、脉管侵犯（LVI）、肿瘤侵犯深度（DTI）、淋巴结转移（LNM）、pTNM分期、体重减轻（BWL）、体重指数（BMI）、NRS2002评分、PG-SGA分级、血红蛋白（HB）、总蛋白（TP）、白蛋白（ALB）、前白蛋白（PAB）及淋巴细胞总数（TLC）显著相关。多因素逻辑回归分析显示，hs-CRP（OR=1.814，95%CI=1.174-2.803；P=0.007）、年龄、ALB、BMI、BWL及TMD是GC患者存在营养不良风险的独立危险因素。同样，非营养不良组和疑似/中度至重度营养不良组均显示，hs-CRP（OR=3.346，95%CI=1.833-6.122；P<0.001）、年龄、HB、ALB、BMI及BWL是GC患者发生营养不良的独立危险因素。
除年龄、ALB、BMI及BWL等常用的营养评估指标外，hs-CRP水平可作为GC患者营养筛查和评估指标。
