我院肿瘤患者体重指数分析及对化疗药物使用的思考

Analysis of Body Mass Index of Cancer Patients in Our Hospital and Consideration on the Use of Chemotherapeutic Drugs

目的分析评价肿瘤患者体重状况,探讨体重指数(BMI)值在性别、癌种、临床分期、各年龄段分布情况、ECOG评分、化疗方案催吐风险分级分类方面的特征。方法选择2018年1月-10月我院肿瘤科收治的年龄≥20岁的500例患者为研究对象,其中男性298例,女性202例。对患者BMI值与年龄、临床分期、癌种、ECOG评分、化疗方案催吐风险分级的相关性进行统计和分析。结果样本总体BMI值为(21.72±3.43)kg·m-2,其中男性为(21.71±3.54)kg·m-2、女性为(21.73±3.28)kg·m-2,差异无统计学意义(P>0.05);分别与2014年中国城乡居民总体BMI值、男性及女性BMI值比较,均明显偏低(P<0.05)。500例患者的诊断结果包括肺癌、肠癌、胃癌等17个癌种。与肿瘤患者整体平均BMI值相比,胃癌和胰腺癌患者的BMI值显著偏低(P<0.05);乳腺癌、卵巢癌及头颈部肿瘤患者的BMI值则明显偏高(P<0.05)。随着患者肿瘤临床分期的增加,BMI值逐渐降低;Ⅳ期患者的BMI值显著低于Ⅱ、Ⅲ期患者(P<0.05)。除20~29岁女性外,其余各年龄段肿瘤患者的BMI值均明显低于中国城乡居民BMI值(P<0.05)。ECOG评分为2分和3分的患者BMI值显著低于评分为0分和1分的患者(P<0.05)。使用高度催吐风险化疗方案的患者,BMI值显著低于使用中、低度催吐风险化疗方案的患者(P<0.05)。结论肿瘤患者BMI值显著低于城乡居民水平,在性别上无明显差异,而在不同癌种、年龄段、临床分期、ECOG评分和化疗方案催吐风险分级方面存在显著差异。

Objective To explore the correlation of body mass index with sex,cancer type,clinical stage,age,ECOG score and risk classification of emetic in chemotherapy regimens.Methods Between January 2018 and October 2018,500 patients over 20 years of old were enrolled in the oncology department of our hospital.Among them,298 were males and 202 were females.The correlation between BMI and age,clinical stage,cancer type,ECOG score and risk classification of emetic in chemotherapy regimens score was analyzed.Results The average BMI of the samples was (21.72±3.43) kg·m-2.It was (21.71±3.54) kg·m-2 for males and (21.73±3.28) kg·m-2 for females.There was no significant difference between males and females (P>0.05).Compared with the data of urban and rural residents in China in 2014,the average BMI for all,for males and for females was respectively decreased (P<0.05).The 500 patients were diagnosed of 17 kinds of cancers,including lung cancer,intestinal cancer,and gastric cancer.The average BMI of patients with gastric cancer and pancreatic cancer were significantly lower than that of overall cancer patients (P<0.05).In addition,patients with breast cancer,ovarian cancer and head and neck cancer had significantly higher BMI (P<0.05).With the increase of clinical stage of cancer patients,BMI gradually decreased.The BMI of patients in stage Ⅳ was significantly lower than that of patients in stage Ⅱ and Ⅲ (P<0.05).Except for the females aging 2019,the BMI of cancer patients of other age groups was respectively lower than that of urban and rural residents in China (P<0.05).The BMI of patients with ECOG scores of 2 and 3 was significantly lower than those of patients with ECOG scores of 0 and 1 (P<0.05).Moreover,the BMI of patients with high emetic risk chemotherapy regimen was significantly lower than that of patients with moderate or low emetic risk chemotherapy regimen (P<0.05).Conclusion The BMI of cancer patients was lower than that of urban and rural residents.There was no significant difference in BMI between males and females.But BMI was significantly different between different types of cancer,age groups,clinical stages,ECOG scores and risk classifications of vomiting in different chemotherapy regimens.