Preoperative Nutritional Risk Index to predict postoperative survival time in primary liver cancer patients

术前的营养风险指数对原发性肝癌患者术后生存时间的影响

Ya-Cong Bo ； Ming-Jie Yao ； Ling Zhang ； Wolde Bekalo Sapa ； Wei-Quan Lu ； Quan-Jun Lu

《Asia Pacific Journal of Clinical Nutrition》 預刊文章 Pp. 29-41

https://doi.org/10.6133/apjcn.2015.24.4.26

摘要

目的：探讨术前营养风险指数（Nutritional Risk Index NRI）对原发性肝癌肝切除术患者术后生存时间的影响。方法：收集河南省肿瘤医院肝胆外科2008年12月1日到2012年12月1日期间的620例原发性肝癌经手术治疗的患者，并对其进行随访。运用NRI筛选营养不良患者（NRI ≤100）。并记录病人的预后和生存状况。运用Kaplan-Meier并log-rank检验分析受试者营养不良和预后的关系。同时采用Cox比例风险模型分析术后生存时间的影响因素。结果：620，名参与者1,3,5年期末累积生存比例分别为49%，分别为33%和29%。Kaplan-Meier并log-rank检验分析表明，非营养不良（NRI ＞100）的患者相比，营养不良的患者术后存活时间更长。NRI ＞100明显与术后生存时间较长。Cox比例风险模型显示，NRI是术后生存时间的独立危险因素，随着NRI降低，患者死亡风险升高。结论：NRI ＞100的患者术后生存时间比NRI ≤100者长。

關鍵字

营养风险指数 ； 术后生存时间 ； 体重减少 ； 原发性肝癌 ； 肝切除术

並列摘要

Objective: We designed this study to determine the predictive value of Nutritional Risk Index (NRI) for postoperative survival time of patients who had undergone hepatectomy for primary liver cancer. Methods: The 620 patients who underwent hepatectomy for primary liver cancer (PLC) in the Department of Hepatobiliary Surgery, Cancer Hospital of Henan Province, Zhengzhou, China from December 1, 2008 to December 1, 2012 were followed up. A nutritional risk index (NRI) was used to screen the patients with malnutrition (NRI≤100). At the same time, the prognosis and survival of the patients were recorded. Kaplan-Meier curve with log-rank test was used to analyze the relationship between malnutrition and prognosis of the subjects. Also the postoperative survival time and its influencing factors were analyzed by Cox proportional hazards model. Results: The cumulative survival probability at 1, 3, and 5 years of the 620 subjects was 49%, 33% and 29% respectively. Kaplan-Meier analysis with log-rank test showed that non-malnourished (NRI values＞100) patients had longer postoperative survival time compared with malnourished patients. NRI values ＜100 was significantly associated with longer postoperative survival time. Cox proportional hazards model showed that NRI was an independent predictor of postoperative survival time and that NRI varied inversely with the risk of death. Conclusion: The patients with NRI values ＞ 100 survived longer than those with NRI values ＜100.

並列關鍵字

Nutritional Risk Index ； postoperative survival time ； weight loss ； primary liver cancer) ； hepatectomy