Ding Zhen, Zhou Lingmei, Zhou Yan, Jin Kemei, Wu Runjinxing, Gui Yihua
Clincal Nutrition Department, Ningbo Medical Center Li Huili Hospital, Zhejiang Province, 315000, China.
Department of Otolaryngology, Head and Neck Surgery, Ningbo Medical Center Li Huili Hospital, Zhejiang Province, 315000, China.
J Clin Biochem Nutr. 2024 Jul;75(1):71-77. doi: 10.3164/jcbn.24-35. Epub 2024 May 21.
We aimed to describe nutritional status and body composition profiles perioperative head and neck cancer (HNC) patients managed with whole-course nutritional support. Scored Nutritional Risk Screening (NRS 2002), Patient-Generated Subjective Global Assessment (PG-SGA), and body composition were conducted. The factors related to weight loss and skeletal muscle mass (SMM) were identified. Lower weight and body composition levels in low skeletal muscle index (SMI≤9.90 kg/m) group were observed. Levels of albumin, prealbumin, prognostic nutritional index (PNI), and lymphocyte-to-monocyte ratio (LMR) were lower than pre-operative, but the values after 2 weeks were higher than 1 week post-operatively (all <0.01). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were increased at 1 and 2 weeks post-operative compared to pre-operative (both <0.01). Post-operatively, NLR at 2 weeks was lowed than 1 week ( = 0.02). A negative correlation was observed between SMM loss and serum prealbumin ( = -0.255, = 0.029). Pre-operative BMI (<0.01), tumor differentiation ( = 0.003), and nutritional risk ( = 0.049) were risk factors for weight loss. In conclusions, for perioperative HNC patients, loss of adipose tissue occurred earlier than muscle. Prealbumin should be considered as an indicator for monitoring of recovery in clinical practice.
我们旨在描述接受全程营养支持治疗的围手术期头颈癌（HNC）患者的营养状况和身体成分特征。进行了营养风险筛查评分（NRS 2002）、患者主观整体评定法（PG-SGA）以及身体成分分析。确定了与体重减轻和骨骼肌质量（SMM）相关的因素。观察到低骨骼肌指数（SMI≤9.90 kg/m）组的体重和身体成分水平较低。白蛋白、前白蛋白、预后营养指数（PNI）和淋巴细胞与单核细胞比值（LMR）水平低于术前，但术后2周的值高于术后1周（均P<0.01）。与术前相比，术后1周和2周中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）升高（均P<0.01）。术后2周的NLR低于1周（P=0.02）。观察到SMM损失与血清前白蛋白之间呈负相关（r=-0.255，P=0.029）。术前体重指数（P<0.01）、肿瘤分化程度（P=0.003）和营养风险（P=0.049）是体重减轻的危险因素。总之，对于围手术期HNC患者，脂肪组织的损失比肌肉更早发生。在临床实践中，前白蛋白应被视为监测恢复情况的指标。
