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结直肠癌患者营养状况控制评分与临床生化指标的相关性研究

Study on the correlation between controlling nutritional status score and clinical biochemical indicators in patients with colorectal cancer.

作者信息

Wang Zhi, Bian Jin, Yuan Jiayan, Zhao Sunyan, Huang Shijia, Wu Rong, Fei Fei

机构信息

Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.

Department of Medical Oncology of PLA Cancer Center, Jinling Hospital, Nanjing, Jiangsu, China.

出版信息

Heliyon. 2024 Mar 5;10(5):e27202. doi: 10.1016/j.heliyon.2024.e27202. eCollection 2024 Mar 15.

Abstract

PURPOSE

The controlling nutritional status (CONUT) score is an important tool for predicting the prognosis of colorectal cancer (CRC); however, its effectiveness is relatively insufficient. This study aimed to screen for more effective clinical indicators as supplements to the CONUT scoring system and improve the predictive value of CRC prognosis.

PATIENTS AND METHODS

Between 2014 and 2020, the clinical information of all CRC patients in our unit was retrospectively collected, and the CONUT scores were calculated based on the levels of serum albumin (ALB), lymphocytes (LC), and total cholesterol. The included patients were divided into the following three groups: normal nutrition (0-1), mild malnutrition (2-4), and moderate-to-severe malnutrition (5-12). The correlations between the CONUT score and baseline characteristics and clinical indicators were evaluated.

RESULTS

This study ultimately included 5014 CRC patients. The nutritional status of patients with colon cancer (CC) was worse than that of rectal cancer (RC). The nutritional status was worse in men than in women. The older the patient, the poorer the nutritional status, and the poorer the nutritional status, the longer the hospital stay. In addition, poor nutritional status in patients is indicated by higher values of neutrophils (NE), monocytes (MC), eosinophils (EOS), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), carcinoembryogenic antigen (CEA), and lower values of white blood cells (WBC), basophils (BAS), haemoglobin (HB), total protein (TP), triglycerides (TG), low density lipoprotein (LDL), aspartate transaminase (AST), and blood urea nitrogen (BUN), which was statistically significant ( < 0.05). Indicators that significantly correlated with the CONUT score reflected the immune nutritional status, including WBC (odds ratio [OR] = 0.036,  < 0.001), NE (OR = 30.815,  < 0.001), MC (OR = 41.388,  < 0.001), EOS (OR = 27.577,  < 0.001), BAS (OR = 0.006,  = 0.046), and LDL (OR = 0.319,  < 0.001).

CONCLUSION

Additional variables such as WBC, NE, MC, EOS, BAS, and LDL may be used as supplementary indicators in the CONUT scoring system to more effectively predict the clinical prognosis of CRC patients.

摘要

目的

控制营养状态(CONUT)评分是预测结直肠癌(CRC)预后的重要工具;然而,其有效性相对不足。本研究旨在筛选更有效的临床指标以补充CONUT评分系统,并提高CRC预后的预测价值。

患者与方法

回顾性收集2014年至2020年间本单位所有CRC患者的临床信息,并根据血清白蛋白(ALB)、淋巴细胞(LC)和总胆固醇水平计算CONUT评分。纳入的患者分为以下三组:营养正常(0 - 1分)、轻度营养不良(2 - 4分)和中重度营养不良(5 - 12分)。评估CONUT评分与基线特征及临床指标之间的相关性。

结果

本研究最终纳入5014例CRC患者。结肠癌(CC)患者的营养状况比直肠癌(RC)患者差。男性的营养状况比女性差。患者年龄越大,营养状况越差,营养状况越差,住院时间越长。此外,患者营养状况差表现为中性粒细胞(NE)、单核细胞(MC)、嗜酸性粒细胞(EOS)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、癌胚抗原(CEA)值较高,而白细胞(WBC)、嗜碱性粒细胞(BAS)、血红蛋白(HB)、总蛋白(TP)、甘油三酯(TG)、低密度脂蛋白(LDL)、天冬氨酸转氨酶(AST)和血尿素氮(BUN)值较低,差异具有统计学意义(P < 0.05)。与CONUT评分显著相关的指标反映了免疫营养状态,包括WBC(比值比[OR] = 0.036,P < 0.001)、NE(OR = 30.815,P < 0.001)、MC(OR = 41.388,P < 0.001)、EOS(OR = 27.577,P < 0.001)、BAS(OR = 0.006,P = 0.046)和LDL(OR = 0.319,P < 0.001)。

结论

WBC、NE、MC、EOS、BAS和LDL等额外变量可作为CONUT评分系统中的补充指标,以更有效地预测CRC患者的临床预后。

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