Li Guomiao, He Lijuan, Sun Hao
Cancer Center, The Second People's Hospital of Neijiang, Neijiang, Sichuan 641000, P.R. China.
Department of Health Management Center, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.
Oncol Lett. 2023 Jul 31;26(3):401. doi: 10.3892/ol.2023.13988. eCollection 2023 Sep.
Patients with gastric cancer with pyloric stenosis frequently have poor nutritional status and preoperative parenteral nutrition has been a common treatment strategy. The present study aimed to explore the predictive ability of the nutritional risk index (NRI) regarding the prognosis of patients with gastric cancer and pyloric stenosis who received preoperative parenteral nutrition. A total of 194 patients with gastric cancer with pyloric stenosis who received preoperative parenteral nutrition at Tthe Second People's Hospital of Neijiang (Neijiang, China) between January 2016 and December 2021 were included. At the same time, 221 patients with gastric cancer without pyloric stenosis who received surgery during the same period were also collected and the clinicopathological characteristics of the patients were compared. The optimal cut-off value of the NRI was determined from the receiver operating characteristic curve and prognostic factors were identified by survival analysis. Finally, a nomogram was constructed to predict the survival probability of patients with gastric cancer. The results indicated that patients with pyloric stenosis exhibited a wide range of unfavorable pathological characteristics and blood parameters. In addition, their overall survival (OS) was significantly worse (P<0.001). Among the patients with pyloric stenosis, there were 120 patients (61.9%) with an NRI <93.42 and 74 patients (38.1%) with NRI ≥93.42. Furthermore, patients with an NRI <93.42 had poorer OS (34.37 months vs. not reached, P=0.004). Of note, age, tumor size, radical resection, NRI and TNM stage were determined to be independent prognostic factors for OS. The C-index of the nomogram was 0.760 (95%CI: 0.688-0.832). In conclusion, the NRI was indicated to be an accurate score reflecting the nutritional status of patients, which was able to predict the clinical outcomes of patients with gastric cancer with pyloric stricture who received preoperative parenteral nutrition. Patients with a low NRI had shorter survival times.
患有幽门狭窄的胃癌患者营养状况往往较差，术前肠外营养一直是一种常见的治疗策略。本研究旨在探讨营养风险指数（NRI）对接受术前肠外营养的胃癌合并幽门狭窄患者预后的预测能力。纳入了2016年1月至2021年12月期间在内江市第二人民医院（中国内江）接受术前肠外营养的194例胃癌合并幽门狭窄患者。同时，还收集了同期接受手术的221例无幽门狭窄的胃癌患者，并比较了患者的临床病理特征。通过受试者工作特征曲线确定NRI的最佳截断值，并通过生存分析确定预后因素。最后，构建了一个列线图来预测胃癌患者的生存概率。结果表明，幽门狭窄患者表现出广泛的不良病理特征和血液参数。此外，他们的总生存期（OS）明显更差（P<0.001）。在幽门狭窄患者中，NRI<93.42的患者有120例（61.9%），NRI≥93.42的患者有74例（38.1%）。此外，NRI<93.42的患者OS较差（34.37个月对未达到，P=0.004）。值得注意的是，年龄、肿瘤大小、根治性切除、NRI和TNM分期被确定为OS的独立预后因素。列线图的C指数为0.760（95%CI：0.688-0.832）。总之，NRI被认为是反映患者营养状况的准确评分，能够预测接受术前肠外营养的胃癌合并幽门狭窄患者的临床结局。NRI低的患者生存时间较短。
