高文君,杨守梅,吴 丹,等.外周血炎症因子水平与原发性肺癌患者营养状况的相关性临床研究[J].肿瘤学杂志,2022,28(10):833-840.
外周血炎症因子水平与原发性肺癌患者营养状况的相关性临床研究
Correlation between Serum Inflammatory Factor Levels and Nutritional Status in Patients with Primary Lung Cancer
投稿时间:2022-07-04  
DOI:10.11735/j.issn.1671-170X.2022.10.B006
中文关键词:  原发性肺癌  营养不良  营养评估  PG?鄄SGA  炎症因子  营养支持治疗
英文关键词:primary lung cancer  malnutrition  nutritional assessment  PG-SGA  inflammatory indicators  nutritional support
基金项目:
作者单位
高文君 中国科学技术大学附属第一医院西区(安徽省肿瘤医院) 
杨守梅 中国科学技术大学附属第一医院西区(安徽省肿瘤医院) 
吴 丹 中国科学技术大学附属第一医院西区(安徽省肿瘤医院) 
刘 杏 中国科学技术大学附属第一医院西区(安徽省肿瘤医院) 
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中文摘要:
      摘 要:[目的]探究原发性肺癌营养不良患者与外周血炎症因子水平的相关性。[方法]对2018年1月至 2021年12月222例住院原发性肺癌患者应用PG-SGA进行营养状况评估,并根据PG-SGA评分将患者分成3组:无或可疑营养不良组、中度营养不良组及重度营养不良组。分析患者营养不良的发生情况及其与临床病理特征、营养指标及外周血多项炎症指标的关系。[结果] 222例原发性肺癌患者中,无或可疑营养不良者占34.2%(76/222),中度营养不良者占36.0%(80/222),重度营养不良者占29.8%(66/222)。3组患者的性别、年龄、病理组织学类型及血脂水平差异均无统计学意义(P>0.05)。随着营养不良程度加重,患者的临床分期较晚,其体质指数、血红蛋白、淋巴细胞计数、前白蛋白、白蛋白、预后营养指数呈逐步下降趋势,差异均有统计学意义(P<0.05)。重度营养不良患者更易出现血小板和D-二聚体的升高,且外周血中性粒细胞计数、单核细胞计数、C-反应蛋白、白细胞介素-6、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值水平更高,而淋巴细胞与单核细胞比值更低,差异均有统计学意义(P<0.05)。营养指标前白蛋白和预后营养指数预测营养不良的最佳截断值分别为163 mg/L和43;炎症因子指标CRP、IL-6、NLR、PLR和LMR预测营养不良的最佳截断值分别为31.5 mg/L、13.5 pg/mL、4.2、177.4和1.9。经营养支持治疗后,中重度营养不良患者营养指标PAB、ALB水平较治疗前明显提高,炎症因子CRP、IL-6水平较治疗前明显降低,差异均有统计学意义(P<0.05)。[结论]原发性肺癌患者营养不良发生率高。PG-SGA评分与炎症因子水平及营养指标相关性较好。营养支持治疗可改善肺癌患者营养状况,降低炎症因子水平,可能会给患者带来临床获益。
英文摘要:
      Abstract: [Objective] To investigate the relationship between serum inflammatory factor levels and nutritional status in lung cancer patients. [Methods] A total of 222 patients with lung cancer admitted in Anhui Provincial Cancer Hospital from January 2018 to December 2021 were enrolled in the study. The nutritional status was evaluated by Patient-Generated Subjective Global Assessment(PG-SGA). According to PG-SGA score, patients were classified as no or suspected malnutrition, moderate malnutrition or severe malnutrition. The relationship of nutritional indicators with clinicopathological and serum inflammatory factors was evaluated. [Results] Among the 222 patients, there were 76 cases in no or suspected malnutrition group(34.2%), 80 cases in moderate malnutrition group(36.0%)and 66 cases in severe malnutrition group(29.8%). There was no significant difference in gender, age, tumor type and blood lipid levels among three groups(P>0.05). The proportion of patients with late clinicopathological stage was higher in the moderate or severe malnutrition group. The BMI, hemoglobin levels, lymphocyte counts, prealbumin, albumin and PNI decreased with the increase of malnutrition degree. Patients with severe malnutrition were more likely to have high platelet count, and elevated D-dimer levels. And they had higher levels of neutrophil count, monocyte count, CRP, IL-6, NLR and PLR levels, while LMR was lower(all P<0.05). The optimum cut-off of PAB and PNI were 163 mg/L and 43 for diagnosis of malnutrition. And the optimum cut-off values of CRP, IL-6, NLR, PLR and LMR for diagnosis of malnutrition were 31.5 mg/L, 13.5 pg/mL, 4.2, 177.4 and 1.9, respectively. After nutritional support, the levels of PAB and ALB in the moderate or severe malnutrition group were significantly increased, and the levels of CRP and IL-6 were decreased(P<0.05). [Conclusion] The incidence of malnutrition is high in lung cancer patients. The score of PG-SGA is well correlated with nutritional indicators and inflammatory indicators. Nutritional support can improve the nutritional condition and reduce the levels of inflammatory factors of patients with lung cancer, which may bring clinical benefits to patients.
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