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目的 :研究术前老年营养风险指数(geriatric nutritional risk index, GNRI)对食管鳞癌患者术后预后的影响。方法:共纳入接受食管鳞癌根治术的患者152例,根据GNRI值,分为营养风险组(GNRI<92)(n=56)和营养无风险组(GNRI≥92)(n=96)。采用Kaplan-Meier法Log-rank检验比较两组患者的生存曲线。采用Cox回归分析方法分析与预后相关的指标。结果:两组患者的血清白蛋白水平、体质量指数、预后营养指数比较差异均有统计学意义(均P<0.05)。营养风险组发生吻合口瘘8例(14.3%),营养无风险组4例(4.2%),差异有统计学意义(P=0.026)。营养风险组患者术后5年无病生存率和总体生存率分别为17.9%和19.9%,营养无风险组分别为34.4%和42.6%,差异均有统计学意义(均P=0.008,0.004)。术前GNRI可作为患者无病生存及总体生存的独立预后因素(P<0.05)。结论:术前GNRI低与食管鳞癌患者术后预后不良密切相关,可作为一种简易方便的评估食管鳞癌患者术后预后的指标。
Abstract：Objective: To investigate the impact of the geriatric nutritional risk index(GNRI) on the outcomes in esophageal squamous cell carcinoma patients who underwent curative esophagectomy. Methods: A total of 152 cases who underwent curative esophagectomy were enrolled in the current study. Patients were categorized as nutrition risk group(GNRI<92)( n=56) or non-nutrition risk group(GNRI≥92)(n=96) according to the cutoff value of the GNRI. The survival between two groups was compared by Kaplan-Meier Log-rank test. Cox regression analysis was performed to determine significant prognostic factors.Results: The GNRI was significantly associated with level of serum albumin, body mass index and prognostic nutritional index(P<0.05). The rate of anastomotic leakage in nutrition risk group and non-nutrition risk group was 4.2% and 14.3% respec-tively. And significant difference was observed(P=0.026). The postoperative 5-year disease-free survival for patients in nutrition risk group and non-nutrition risk group was 17.9% and 34.4%, respectively. And significant difference was observed(P=0.008).The postoperative 5-year overall survival for patients in nutrition risk group and non-nutrition risk group was 19.9% and42.6%, respectively. And significant difference was observed(P=0.008). Moreover, GNRI was an independent prognostic factor for 5-year disease-free survival and overall survival(P<0.05). Conclusion: A low preoperative GNRI was closely associated with worse outcome for patients with esophageal squamous cell carcinoma after curative surgery. GRNI is a simple and reliable predictor of the postoperative survival in esophageal squamous cell carcinoma.
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基本信息:
DOI：10.16424/j.cnki.cn32-1807/r.2021.03.011
中图分类号:R735.1
引用信息:
[1]刘雷,施民新,陆海敏等.老年营养风险指数对食管鳞癌患者术后预后的影响[J].南通大学学报(医学版),2021,41(03):240-244.DOI:10.16424/j.cnki.cn32-1807/r.2021.03.011.
基金信息:
南通市肿瘤医院博士科研启动基金项目(BS201909)