原发性胃癌患者体重指数与术后生存状况等指标的关联及预后分析

Correlation and prognosis analysis between body mass index and postoperative survival condition in patients with primary gastric cancer

目的探讨体重指数(BMI)降低对原发性胃癌患者各项指标尤其是术后生存状况的影响。方法选取228例原发性胃癌患者为研究对象,分为BMI未降低组(0%,n=90)、BMI轻度降低组(<10%,n=102)及BMI重度降低组(≥10%,n=36)。比较三组患者的临床病理资料,采用Kaplan-Meier法计算生存率,并行Logrank检验进行比较;采用Cox比例风险模型进行预后结局的影响因素分析。结果不同BMI组在T、N、M分期、淋巴结转移率、根治程度等方面比较,差异均有统计学意义(χ2分别=12.93、13.54、6.88、10.32、6.78、6.36、P均<0.05)。BMI重度降低组的5年生存率明显低于BMI未降低组,差异有统计学意义(χ2=5.19、P<0.05)。Cox比例风险模型结果表明BMI降低、T、N分期、淋巴结转移率和癌胚抗原水平是影响胃癌患者预后的影响因素(HR分别=1.26、1.83、1.61、2.02、1.74,P均<0.05)。结论 BMI降低超过10%的原发性胃癌患者的生存率较差,BMI降低是影响胃癌术后生存状况的独立危险因素。

Objective To investigate the effect of body mass index（BMI） on postoperative survival condition of patients with primary gastric cancer. Methods A total of 228 patients with primary gastric cancer were enrolled for the study and divided into non-decreased BMI group（0%,n=90）,slightly decreased BMI group（10%,n=102）and sever decreased BMI group（≥10%,n=36）. The clinical pathological data were compared among the three groups. Kaplan-Meier method was used to calculate the survival rate,and Logrank test was used to compare. Cox proportional hazard model was performed to analyze the influence factors of the prognosis. Results There were significant differences in T,N,M stage,lymph node metastasis rate,degree of cure among three groups（χ2=12.93,13.54,6.88,10.32,6.78,6.36,P 0.05）. The 5-year survival rates of sever decreased BMI group was lower than non-decreased BMI group（χ2=5.19,P0.05）. Result of Cox proportional hazard model showed that decreased BMI,T,N stage,lymph node metastasis rate and carcino-embryonic antigen level were the influencing factors of the prognosis of gastric cancer patients（HR =1.26,1.83,1.61,2.02,1.74,P 0.05）. Conclusion The survival rate of patients with primary gastric cancer and BMI decreased more than 10% is worse,decreased BMI is the independent risk factor of postoperative survival condition.