胶质母细胞瘤患者术前营养风险评分对术后临床结局的影响

Effects of perioperative nutritional risk scores on postoperative clinical outcomes in patients with glioblastoma multiforme

目的分析胶质母细胞瘤患者术前营养风险评分对术后临床结局的影响.方法将首都医科大学附属北京天坛医院2018年12月—2019年7月收治的72例胶质母细胞瘤患者作为研究对象,对其临床资料进行回顾性分析,根据NRS 2002营养风险筛查量表评分,将研究对象分为高风险组(>5分,34例)与低风险组(≤5分,38例).采用χ2检验分析营养风险状态与患者临床病理特征之间的关系.使用单因素及多因素Cox回归分析影响患者预后的危险因素.采用Kaplan-Meier生存分析及Log-rank检验比较高风险组与低风险组患者生存时间差异.结果χ2检验显示,MGMT启动子甲基化与未甲基化、接受放射治疗与未接受放射治疗、接受化疗与未接受化疗患者的营养风险评分差异具有统计学意义(P<0.05).高风险组患者(营养风险评分>5分)的生存时间低于低风险组患者(营养风险评分≤5分)的生存时间(P<0.05).单因素及多因素Cox生存分析结果显示,高营养风险评分是胶质瘤患者预后的危险因素(P<0.05).结论胶质母细胞瘤患者的术前营养风险评分可作为预测患者术后临床结局的有用指标.

Objective To analyze the effects of perioperative nutritional risk scores on postoperative clinical outcomes in patients with glioblastoma multiforme(GBM).Methods Totally 72 patients with GBM treated in Beijing Tiantan Hospital,Capital Medical University between December 2018 and July 2019 were selected.Their clinical data were retrospectively analyzed.The subjects were divided into high-risk(>5 points,n=34)and low-risk(≤5 points,n=38)groups according to the scores of Nutritional Risk Screening(NRS 2002).Chi-square test was used to analyze the relationship between nutritional risk and patients,clinical pathological characteristics.Univariate and multivariate Cox regression analyzes were used to analyze the risk factors affecting patients;prognosis.Kaplan-Meier survival analysis and Log-rank test were employed to the difference in survival time between high-risk and low-risk groups.Results Chi-square test revealed that there was statistically significant difference in nutritional risks between patients with methylated an unmethylated MGMT promotor,with and without radiotherapy,and with and without chemotherapy(P<0.05).The survival time of the highrisk group(NRS 2002 score>5)was shorter than that of the low-risk group(NRS 2002 score≤5)(P<0.05).Univariate and multivariate Cox regression analyzes showed that high nutritional risk scores were the risk factor to the prognosis of patients with GBM(P <0.05).Conclusions Perioperative nutritional risk scores in patients with GBM may serve as a useful indicator for predicting the postoperative clinical outcome of these patients.