老年结直肠癌患者术前营养风险筛查2002评分对预后的预测效果分析

Predictive effect of preoperative nutritional risk screening 2002 score on prognosis in elderly patients with colorectal cancer

目的分析老年结直肠癌患者术前营养风险筛查2002(nutritional risk screening 2002,NRS 2002)评分对预后的预测效果。方法选取合肥市第八人民医院2020年1月至2023年12月收治的87例老年结直肠癌患者作为研究对象,按照患者术前NRS 2002评分,将患者分为营养风险组(NRS 2002评分≥3分)和营养正常组(NRS 2002评分<3分)。比较两组患者临床资料、手术情况和恢复情况、无事件生存(event-free survival,EFS)时间和总生存(overall survival,OS)时间,并采用多因素Cox比例风险回归模型分析影响患者EFS时间和OS时间的相关因素。结果87例患者中,46例患者NRS 2002评分≥3分,占比52.87%。营养风险组患者与营养正常组体重指数(body mass index,BMI)、TNM分期、分化程度、肿瘤最大径比较差异均有统计学意义(均P<0.05)。营养风险组患者术后住院时间显著长于营养正常组(P<0.05),术后并发症发生率显著高于营养正常组(P<0.05),中位EFS时间和中位OS时间均显著短于营养正常组(均P<0.05)。多因素Cox比例风险回归分析显示,NRS 2002评分≥3分、肿瘤最大径≥3 cm、TNM分期Ⅲ期、低分化均为影响老年结直肠癌预后的独立危险因素(均P<0.05),但BMI≥18.5 kg/m2为保护因素(P<0.05)。结论老年结直肠癌患者营养状况普遍较差,且营养风险与患者术后恢复时间延长、并发症发生率升高和EFS时间、OS时间的缩短显著相关,且高NRS 2002评分和低BMI也与患者预后不良密切相关。

Objective To analyze the predictive effect of nutritional risk screening 2002(NRS 2002)score on prognosis of elderly patients with colorectal cancer.Method 87 elderly patients with colorectal cancer admitted to Hefei No.8 People's Hospital from January 2020 to December 2023 were divided into nutrition risk group(NRS 2002 score≥3 scores)and normal nutrition group(NRS 2002 score<3 scores)according to their preoperative NRS 2002 score.The clinical data,operation and recovery of patients between the two groups were compared,and the event-free survival(EFS)time and overall survival(OS)time of patients with different clinical data and nutritional status were compared.The related factors affecting EFS time and OS time were summarized by multivariate Cox proportional hazard regression model.Result Among 87 patients,46 patients had NRS 2002 score≥3 scores,accounting for 52.87%.There were significant differences in body mass index(BMI),TNM staging,differentiation degree and maximum tumor diameter between the nutritional risk group and the nutritional normal group(all P<0.05).The postoperative hospitalization time of nutritional risk group was longer than normal nutritional group(P<0.05),the incidence of postoperative complications of nutritional risk group were higher than normal nutritional group(P<0.05).The median EFS time and median OS time in nutrition risk group were lower than those in normal nutrition group,and the difference was statistically significant(all P<0.05).Multivariate Cox proportional hazard regression analysis showed that NRS 2002 score≥3 scores,the largest tumor diameter≥3 cm,TNM stageⅢand poor differentiation were all independent risk factors affecting the prognosis of elderly colorectal cancer(all P<0.05),and BMI≥18.5 kg/m2 was the protective factor(P<0.05).Conclusion The nutritional status of elderly patients with colorectal cancer is generally poor,and the existence of nutritional risks is related to prolonged postoperative recovery time,increased incidence of complications and shortened EFS time and OS time.Besides traditional factors such as tumor diameter,TNM staging and differentiation degree,higher NRS 2002 score and lower BMI are also closely related to poor prognosis of patients.