摘要
目的 探讨术前控制营养状态(controlling nutritional status,CONUT)评分对非小细胞肺癌(non-small cell lung cancer,NSCLC)患者根治术后复发转移的预测价值。方法 回顾性分析2013年1月至2017年5月于广州市番禺中心医院行根治性手术治疗的98例NSCLC患者的临床资料,根据术前CONUT评分将患者分为高CONUT评分组(≥3分,30例)与低CONUT评分组(<3分,68例),比较两组患者的临床病理特征和随访结果,并采用单因素组间比较和多因素Cox回归分析探讨患者术后复发转移的独立预测因素。结果 高CONUT评分组患者的年龄显著大于低CONUT评分组(P<0.05),低分化、TNM分期为Ⅲ期、有淋巴结转移的患者占比均显著高于低CONUT评分组(均P<0.05)。全部患者术后均至少随访5年,随访期内共有53例患者出现复发转移,总发生率为54.1%,包括18例局部复发、26例远处转移、9例局部复发伴远处转移;随访期间内共有20例患者死亡,总生存率为79.6%。高CONUT评分组患者术后5年复发转移率、总生存率均显著高于低CONUT评分组(均P<0.05)。复发转移组患者的年龄、肿瘤最大径均显著大于无复发转移组(均P<0.05),低分化、TNM分期为Ⅲ期、有淋巴结转移的患者占比均显著高于无复发转移组(均P<0.05),术后靶向治疗的患者占比显著低于无复发转移组(P<0.05)。多因素Cox回归分析结果表明,TNM分期为Ⅲ期、CONUT评分≥3分均为NSCLC患者根治术后复发转移的独立预测因素(均P<0.05)。结论 术前CONUT评分能有效预测NSCLC患者术后复发转移,是其独立预测因素,有助于临床的早期筛查和干预。
Objective To analyze the predictive value of controlling nutritional status (CONUT) score in recurrence and metastasis of patients with non-small cell lung cancer (NSCLC) after radical surgery.Method The clinical data of 98 patients with NSCLC who underwent radical surgery in Guangzhou Panyu Central Hospital from January 2013 to May 2017 were retrospectively analyzed.According to the preoperative CONUT scores,the patients were divided into high CONUT score group (≥3 points,30 cases) and low CONUT score group (<3 points,68 cases).The clinicopathological features and follow-up results of patients betweenthe two groups were compared,and the independent predictors of postoperative recurrence and metastasis were explored by univariate inter-group comparison and multivariate Cox regression analysis.Result The age of patients in high CONUT score group was significantly higher than that in low CONUT score group (P<0.05),and the proportion of patients with low differentiation,TNM stage Ⅲ and lymph node metastasis were significantly higher than those in low CONUT score group (all P<0.05).All patients were followed up for at least 5 years after radical surgery.During the follow-up period,53 patients had recurrence and metastasis,with a total incidence of 54.1%,including 18 local recurrence,26 distant metastasis and 9 local recurrence with distant metastasis.During the follow-up period,20 patients died,and the overall survival rate was 79.6%.The recurrence and metastasis rates and the overall survival rate at 5 years after radical surgery in high CONUT score group were significantly higher than those in low CONUT score group (all P<0.05).The age and the maximum diameter of tumor in patients in recurrence and metastasis group were significantly higher than those in no-recurrence and metastasis group (all P<0.05),the proportion of patients with low differentiation,TNM stage Ⅲ and lymph node metastasis were significantly higher than those in no-recurrence and metastasis group (all P<0.05),the proportion of patients with targeted therapy after radical surgery was significantly lower than that in recurrence and metastasis group (P<0.05).Multivariate Cox regression analysis showed that TNM stage Ⅲ and CONUT score ≥3 points were both independent predictors of recurrence and metastasis in patients with NSCLC after radical surgery (all P < 0.05).Conclusion The preoperative CONUT score of patients with NSCLC can effectively predict the recurrence and metastasis after radical surgery.It is an independent predictor and is helpful for early clinical screening intervention.
作者
张耀森
卢国杰
钟惠铃
高建伟
Zhang Yaosen;Lu Guojie;Zhong Huiling;Gao Jianwei(Department of Thoracic Surgery,Guangzhou Panyu Central Hospital,Guangzhou 511400,China)
出处
《肿瘤综合治疗电子杂志》
2022年第4期71-75,共5页
Journal of Multidisciplinary Cancer Management(Electronic Version)
基金
广州市科技计划项目(202102080537)。
关键词
控制营养状态评分
非小细胞肺癌
复发转移
预测价值
Controlling nutritional status
Non-small cell lung cancer
Recurrence and metastasis
Predictive value
