结直肠癌患者术前NRS2002评分对生存的预测价值:基于DACCA数据库的分析

The predictive value of preoperative NRS2002 score for survival in patients with colorectal cancer:an analysis based on the DACCA database

目的通过对四川大学华西医院结直肠癌数据库(Database of Colorectal Cancer,DACCA)进行数据挖掘,评估患者初诊时NRS2002评分与长期生存的关系。方法选取DACCA数据库2023年11月24日版本,比较NRS2002评分<3分和≥3分组患者的临床病理资料,并探索NRS2002评分对生存的影响。结果本研究共筛选出723例患者,其中NRS评分<3分者585例(80.9%),NRS评分≥3分者138例(19.1%)。723例患者均获访,随访时间1~78个月,中位随访时间为34个月。NRS评分<3分组患者的中位生存时间为35个月,NRS评分≥3分组患者的中位生存时间为31个月。随访期间生存589例(81.5%),其中无瘤生存515例(71.2%),带瘤生存74例(10.2%);死亡134例(18.5%),其中癌性死亡126例(17.4%),非癌死亡8例(1.1%)。多因素logistic回归分析结果表明,在控制手术根治程度、辅助治疗、高血压、年龄、肿瘤分化程度、TNM分期后,NRS评分不是影响结直肠癌患者生存的因素(RR=0.98,P=0.875)。结论NRS评分并不是结直肠癌生存的预测因素,这可能是因为尽管患者在术前会有营养风险,但是伴随患者手术及术后长期康复,最终对长期生存的影响较小。

Objective By mining data from the Database of Colorectal Cancer(DACCA)at West China Hospital of Sichuan University,this study aims to evaluate the relationship between nutritional risk screening(NRS)2002 scores at initial diagnosis and long-term survival in patients.Methods The DACCA database version from November 24,2023,was selected to compare the clinicopathological data of patients with NRS2002 scores<3 and≥3,and to explore the impact of NRS2002 scores on survival.Results A total of 723 patients were screened,with 585(80.9%)had NRS2002 scores<3 and 138(19.1%)had NRS2002 scores≥3.All 723 patients were followed up,with a follow-up period ranging from 1 to 78 months and a median follow-up time of 34 months.The median survival time for patients with NRS2002 scores<3 was 35 months,while it was 31 months for those with NRS scores≥3.During the follow-up period,589 patients(81.5%)survived,including 515(71.2%)tumor-free survivors and 74(10.2%)survivors with tumors.There were 134 deaths(18.5%),including 126 cancer-related deaths(17.4%)and 8 non-cancer-related deaths(1.1%).Multivariate logistic regression results showed that after controlling for 6 factors including age,radical surgery,adjuvant therapy,hypertension,differentation,and TNM staging,NRS2002 score was not a factor affecting the survival of colorectal cancer patients(RR=0.98,P=0.875).Conclusion NRS2002 score is not a predictive factor for the survival of colorectal cancer patients,possibly because although patients may have nutritional risks preoperatively,the long-term impact on survival is minimal following surgery and postoperative recovery.