2种营养状况评分评估高级别T1期膀胱癌患者预后的效果比较

Comparison in effect of two nutritional status scores in evaluating prognosis of high-grade T1 stage bladder cancer

目的比较营养风险筛查表2002(NRS-2002)评分和术前控制营养状况(CONUT)评分评估高级别T1期膀胱癌患者预后的效果。方法本研究纳入96例行经尿道膀胱肿瘤切除术(TURBT)的高级别T1期膀胱癌患者,均行NRS-2002评分。检测术前血清白蛋白、外周淋巴细胞计数和总胆固醇,并计算CONUT评分。根据患者NRS-2002、CONUT评分情况将96例患者分为低NRS组(n=60)和高NRS组(n=36)、低CONUT组(n=53)和高CONUT组(n=43)。比较不同组别患者术后恢复情况和生存状况。结果高CONUT组及高NRS组下床活动时间、住院时间显著长于低CONUT组及低NRS组,差异有统计学意义(P<0.05)。生存分析显示,高NRS组和低NRS组无进展生存期(PFS)比较,差异无统计学意义(P>0.05),但低NRS组总生存期(OS)高于高NRS组,差异有统计学意义(P<0.05)。低CONUT组PFS及OS均高于高CONUT组,差异有统计学意义(P<0.05)。NRS评分是OS的相关因素但并非独立影响因素,CONUT评分是PFS及OS的独立影响因素。结论膀胱癌患者术前NRS及CONUT评分均与预后相关,但CONUT评分预后价值优于NRS评分。

Objective To compare effect of Nutrition Risk Screening Scale 2002(NRS-2002)and Controlling Nutritional Status(CONUT)score in evaluating prognosis of high-grade T1 stage bladder cancer.Methods A total of 96 cases of high-grade T1 stage bladder cancer treated by transurethral rescetion of bladder tumor(TURBT)were collected.All patients were evaluated by NRS-2002 score.Serum albumin,peripheral lymphocyte count and total cholesterol were measured and CONUT score was calculated.These patients were divided into low NRS group(n=60)and high NRS group(n=36),low CONUT group(n=53)and high CONUT group(n=43)according to conditions of NRS-2002 and CONUT scores.The recovery and survival status of patients in different groups were compared.Results Bed-off ambulance time and hospital stay in the high CONUT group and the high NRS group were significantly longer than those in the low CONUT group and low NRS group(P<0.05).Survival analysis showed that there was no difference in progression-free survival(PFS)between the high NRS group and low NRS group(P>0.05),but the overall survival(OS)of the low NRS group was significantly better than that of the high NRS group(P<0.05).PFS and OS in the low CONUT group were significantly higher than those in high CONUT group(P<0.05).NRS was a related factor but not an independent factor of OS,while CONUT score was an independent factor of both PFS and OS.Conclusion The preoperative NRS and CONUT scores of bladder cancer patients were both correlated with prognosis,but the prognostic value of CONUT score is better than that of NRS score.