Center of Cancer, The First Hospital of Jilin University, Changchun, 130021, China.
Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China.
Sci Rep. 2023 Oct 16;13(1):17570. doi: 10.1038/s41598-023-43736-0.
The aim of this study was to explore the impact of Geriatric Nutritional Risk Index (GNRI) and body water component (BWC) on the survival of colorectal cancer (CRC) patients and whether the combined effect had a potential prognostic and predictive efficacy. We evaluated the accuracy of GNRI for malnutrition and estimated the predictive capacity of BWC for survival. Kaplan-Meier survival curves and cox regression analyses were used to examine the prognostic effects. A nutrition-water score (NWS) model was developed and evaluated the survival predictive power. GNRI and extracellular water-to-intracellular water ratio (ECW/ICW) were integrated, with the cut-off values of 103.5 and 63.7%. Lower GNRI and higher ECW/ICW were independent risk factors for poor prognosis in CRC patients. The combination of the two into the NWS model demonstrated a higher risk of death for patients with NWS ≥ 1 compared to those with NWS of 0. NWS showed a better predictive capability compared to GNRI and ECW/ICW, with the concordance index of 0.681. Our study demonstrates GNRI and ECW/ICW's prognostic utility in CRC, with their combination improving survival prediction to help guide patient-centered treatment.
本研究旨在探讨老年营养风险指数（GNRI）和体水成分（BWC）对结直肠癌（CRC）患者生存的影响，以及两者联合的潜在预后和预测效果。我们评估了 GNRI 对营养不良的准确性，并估计了 BWC 对生存的预测能力。采用 Kaplan-Meier 生存曲线和 Cox 回归分析来检验预后效果。开发了一个营养-水评分（NWS）模型，并评估了其对生存的预测能力。GNRI 和细胞外水与细胞内水比值（ECW/ICW）的整合，截断值分别为 103.5 和 63.7%。较低的 GNRI 和较高的 ECW/ICW 是 CRC 患者预后不良的独立危险因素。将两者整合到 NWS 模型中，NWS≥1 的患者死亡风险明显高于 NWS 为 0 的患者。NWS 与 GNRI 和 ECW/ICW 相比，具有更好的预测能力，一致性指数为 0.681。本研究表明 GNRI 和 ECW/ICW 在 CRC 中的预后价值，两者联合可提高生存预测能力，有助于指导以患者为中心的治疗。
