营养风险筛查评分在乳腺癌预后中应用研究

Application of nutritional risk screening score in predicting of prognosis in patients with breast cancer

R的:观察营养风险筛查评分在乳腺癌预后判断中的评估价值。方法:回顾性研究安徽医科大学附属宿州医院肿瘤外科2014年1月至2018年6月收治的乳腺癌病人100例,所有病人入院后进行评估。包括身高、体质量等,并进行血液检查,主要包括血常规及肝肾功能。乳腺癌病人行新辅助化疗,方案为ET(表柔比星75 mg/m,+多西他赛75 mg/m^2). 21d为一周期。共进行六程化疗。观察营养风险筛査评分与乳腺癌新辅助化疗关系;以及营养风险筛查评分与生存率、预后的关系。结果:营养风险筛查评分与年龄、月经状态无显著相关性(P >0.05)0与肿瘤大小、淋巴结情况、激素受体情况、Her-2状态有相关性(P<0.05)。营养风险筛查评分ROC曲线下面积为曲线下面积0.7&约登指数0.55 ,(95%CI: 0.76 ~ 0.81 )。乳腺癌新辅助化疗结果为CR 25例,PR 45例,SD 21例,PD9例,治疗结果与营养风险评分有显著性差异(P = 0.001 ).乳腺癌新辅助化疗高评分组中位无病生存期为20(95%CI: 18.57 ~ 21.42)个月;低评分组中位无病生存期为34(95%(31:26.67 ~41.33)个月,两组曲线有显著性差异(P= 0.001)。乳腺癌病人预后COX多因素分析其治疗效果与肿瘤大小、营养风险筛查评分、Her-2有相关性。结论:营养风险筛查评分在乳腺癌中营养风险诊断中具有良好的诊断作用营养风险筛查评分在乳腺癌新辅助治疗效果、预后判断中具有重要的作用。

Objective: To explored the role of nutritional risk screening score in the diagnosis and prognosis of breast cancer. Methods^ Retrospective study was conducted from January 2014 to June 2018 on 100 patients with breast cancer in the department of the oncology Surgery, Affiliated Suzhou Hospital of Anhui Medical University. Nureition status were evaluated after admission. Height, weight and blood tests, blood routine, liver and kidney function were collected. Patients received neoadjuvant chemotherapy with ET (epirubicin 75 mg/m^2 + docetaxel 75 mg/m^2) for 21 days as a cycle, and 6 courses of chemotherapy were given to patients. The relationship of nutritional risk screening score and neoadjuvant chemotherapy as well as the survival rate and prognosis was evaluated. Result: No significant association between nutritional risk screening score and clinical pathology in single factor analysis with age and menstrual status (P > 0.05) was found. There was significant differences in terms of tumor size, lymph node status, hormone receptor status and Her-2 status (P < 0.05). The area under ROC curve was 0.78, Yoden index was 0.55 and 95% CI (0.76 ?0.81). The neoadjuvant chemotherapy for breast cancer were CR25 cases, PR45 cases, SD21 cases, and PD 9 cases, respectively (P = 0.001). The median disease-free survival was 20 (95% CI: 18.57 ?21.42) months in high neoadjuvant chemotherapy score group;and 34(95% CI :26.67 ~ 41.33) months in low neoadjuvant chemotherapy score group (P = 0.001). COX multivariate analysis showed that the therapeutic effect was correlated well with tumor size, nutritional risk screening score, and Her-2. Conclusions Nutritional risk screening score has a diagnostic role in the malnutrition in breast cancer. Nutritional risk screening score plays an important role in predicting neoadjuvant therapy and prognosis in breast cancer.