营养风险指数在可切除肝细胞癌患者术后并发症及预后预测中的作用

doi:10.11904/j.issn.1002-3070.2023.03.008

摘要/Abstract

摘要： 目的探讨营养风险指数(NRI)对于可切除肝细胞癌(HCC)患者术后并发症和预后的预测价值。方法回顾性分析2016年1月—2017年12月哈尔滨医科大学附属第一医院收治入院的137例行根治性肝切除的HCC患者的临床资料,ROC曲线评价NRI对肝切除术后的治疗效果,并确定最佳诊断点为99,将患者分为高NRI组(NRI≥99)与低NRI组(NRI＜99)。分析术后并发症的独立危险因素并对比两组患者发生术后并发症的情况。分析NRI与HCC患者无病生存期(DFS)和总生存期(OS)的关系。结果相较于高NRI组患者,低NRI组患者术后并发症发生率更高且更易发生严重并发症(P＜0.05)。多因素logistic回归分析结果显示,NRI、CNLC分期和手术时间是HCC患者发生术后并发症的独立危险因素(P＜0.05)。多因素Cox回归分析结果显示,NRI、年龄、肿瘤大小及CNLC分期为DFS的独立预测因素(P＜0.05);NRI、肿瘤大小、CNLC分期以及高血压病史为OS的独立预测因素(P＜0.05)。结论低NRI是HCC患者发生术后并发症的独立危险因素,且NRI对HCC患者的生存预后具有独立预测价值,与患者的DFS和OS呈正相关。

关键词: 营养风险指数, 肝细胞癌, 术后并发症, 预后

Abstract: Objective The aim of this study was to explore the predictive value of nutritional risk index(NRI)for postoperative complications and prognosis in patients with resectable hepatocellular carcinoma(HCC). Methods The clinical data of 137 patients with HCC after radical hepatectomy admitted to the First Affiliated Hospital of Harbin Medical University from January 2016 to December 2017 were retrospectively analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the therapeutic effect of NRI after hepatectomy,and the optimal diagnosis point was determined to be 99.The patients were divided into the high NRI group(NRI≥99)and the low NRI group(NRI＜99).The independent risk factors of postoperative complications were analyzed and the postoperative complications were compared between the two groups.The relationship between NRI and disease-free survival(DFS)or overall survival(OS)was analyzed in HCC patients. Results Compared with patients in the high NRI group,HCC patients in the low NRI group had a higher incidence of postoperative complications and were more prone to serious complications(P＜0.05).The results of multivariate logistic analysis showed that NRI,CNLC stage and surgical time were independent risk factors for postoperative complications in HCC patients(P＜0.05).The results of multivariate Cox regression analysis showed that NRI,age,tumor size and CNLC stage were independent predictors of DFS(P＜0.05).NRI,tumor size,CNLC stage,and history of hypertension were independent predictors of OS(P＜0.05). Conclusion Low NRI is an independent risk factor for postoperative complications in HCC patients,and NRI has an independent predictive value for the prognosis of HCC patients,which is positively correlated with DFS and OS of patients.

Key words: Nutritional risk index, Hepatocellular carcinoma, Postoperative complications, Prognosis

中图分类号:

R735.7

崔永康, 于承平, 许浩志, 马新宇, 麻勇, 李林强. 营养风险指数在可切除肝细胞癌患者术后并发症及预后预测中的作用[J]. 实用肿瘤学杂志, 2023, 37(3): 243-251.

CUI Yongkang, YU Chengping, XU Haozhi, MA Xinyu, MA Yong, LI Linqiang. Effects of nutritional risk index in predicting postoperative complications and prognosis of patients with resectable hepatocellular carcinoma[J]. Journal of Practical Oncology, 2023, 37(3): 243-251.

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链接本文: http://journal09.magtechjournal.com/Jwk3_syzlxzz/CN/10.11904/j.issn.1002-3070.2023.03.008

http://journal09.magtechjournal.com/Jwk3_syzlxzz/CN/Y2023/V37/I3/243

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