老年人营养风险指数预测结直肠癌老年患者的预后:多中心研究
Kazuki Otani1, Keisuke Kazama2, Toru Aoyama2
1Department of Surgery, Yokohama City University, Yokohama, Japan otani.kaz.tt@yokohama-cu.ac.jp.
Anticancer research
|August 28, 2025
概括
老年营养风险指数 (GNRI) 预测了老年结直肠癌患者的长期结果. 低GNRI得分表明整体存活率和无复发存活率较低,强调了其预后价值.
科学领域:
- 老年瘤学
- 外科瘤学
- 营养科学
背景情况:
- 结肠直肠癌 (CRC) 构成了全球重大健康挑战,尤其影响老年人群.
- 老年CRC患者普遍存在营养不良,对治疗效果和预后产生负面影响.
- 老年人营养风险指数 (GNRI) 是评估老年人营养状况的有效工具.
研究的目的:
- 在接受结直肠癌治疗的老年患者中,研究术前老年营养风险指数 (GNRI) 与长期预后之间的关联.
- 确定GNRI是否可以作为该患者队列的整体存活率 (OS) 和无复发存活率 (RFS) 的独立预后因素.
主要方法:
- 一项多中心的回顾性队列研究,涉及65岁及以上的1, 176名患有0- III期结直肠腺癌的患者.
- 患者分为高GNRI (GNRI ≥98) 和低GNRI (GNRI <98) 的两组.
- 使用Kaplan- Meier和Cox比例危险模型分析了总生存率 (OS) 和无复发生存率 (RFS).
主要成果:
- 与高GNRI组相比,低GNRI组的女性,右侧结肠癌,晚期T期瘤和术后并发症的患病率较高.
- 多变量分析证实GNRI是OS和RFS的独立预后因素.
- 三年后的OS率为91. 4% (高GNRI) 和80. 6% (低GNRI),三年后的RFS率为84. 8% (高GNRI) 和73. 8% (低GNRI).
- 血源性复发在低GNRI组 (16. 7%) 的频率明显高于高GNRI组 (10. 5%).
结论:
- 术前GNRI是老年CRC患者长期预后的重要独立因素.
- 它提供了有价值的预测信息,补充了传统的分期系统.
- 这种易于计算的指数可以整合到临床实践中,以识别需要加强手术前治疗的高风险患者.
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