摘要
目的探讨体质指数（BMI）对胃癌患者术后短期结局及长期生存的影响。方法回顾性分析2010年1-6月间在安徽医科大学第一附属医院行胃癌根治术并具有完整随访资料的153例胃癌患者的临床资料。根据BMI（kg／m。）将患者分为低体质量组（BMI〈18．5，23例）、正常体质量组（18．5≤BMI〈25．0，95例）和超重肥胖组（BMI≥25．0，35例）。比较3组患者临床病理特征及术后临床结局。结果低体质量组患者术前血红蛋白为（106．1±13．8）∥L，明显低于正常体质量组[（113．5±5．2）∥L]和超重肥胖组[（123．5±8．7）g／L]，差异有统计学意义（，=3．265，P=0．041）；白蛋白水平[（38．7±2．5）g／L]也明显低于正常体质量组和超重肥胖组[（41．3±0．8）g／L和（43．5±1．4）g/L]，差异也有统计学意义（F=8．516，P=0．000）。低体质量组患者肿瘤位于胃底贲门部的比例也相对较低[34．8％（8／23）比68．4％（65／95）和62．9％（22／35），x。=8．913，P=0．012]。3组患者年龄、手术时间、术中出血量、淋巴结检出数、淋巴结转移率、肿瘤分期、术后并发症发生率及术后住院时间方面的差异则无统计学意义（均P〉0．05）。低体质量组、正常体质量组和超重肥胖组术后5年生存率分别为43．5％、50．5％和65．7％，差异无统计学意义（P=0．189）。进一步按肿瘤部位和BMI进行亚组分析，结果显示，低体质量胃底贲门癌患者5年生存率明显高于超重肥胖胃体胃窦癌患者（25．0％比84．6％，P=0．004）。结论BMI总体上并不影响胃癌患者术后短期结局和长期生存，但加强营养、维持正常体质量对于低体质量、尤其是胃窦癌患者的长期生存或可有一定意义。
Objective To explore the effect of body mass index （BMI） on postoperative short- term prognosis and survival rate of gastric cancer patients. Methods Clinical and follow-up date of 153 gastric cancer cases undergoing radical operation in our hospital from January to June 2010 were retrospectively analyzed. According to BMI, patients were divided into low group （BMI 〈 18.5, 23 cases）, normal group （ 18.5 ≤ BMI 〈 25.0, 95 cases） and high group （BMI ≥ 25.0, 35 cases）. Clinicopathological features and outcomes were compared the among three groups. Results Among three groups, the differences in operation time, intraoperative blood loss, number of lymph node retrieved, postoperative hospital stay, lymph node metastasis rate, tumor staging and postoperative complication morbidity were not statistically significant （all P 〉 0.05）. Preoperative hemoglobin in the low group was significantly lower as compared to normal and high groups [（106.1 ± 13.8） g/L vs. 113.5 ± 5.2） g/L and （123.5 ± 8.7） g/L, F= 3.265, P= 0.041], and so was the preoperative albumin [（38.7 ±2.5） g/L vs. （41.3 ± 0.8） g/L and （43.5 ± 1.4） g/L, F= 8.516, P= 0.000]. The ratio of gastric cardiac cancer in the low group was significantly lower as compared to the normal and high groups [34.8%（8/23） vs. 68.4% （65/95） and 62.9% （22/35）, x2 = 8.913, P = 0.012]. Five-year survival rate of the low,normal and high groups were 43.5%, 50.5% and 65.7% respectively （P = 0.189）. Subgroup analysis showed that the 5-year survival rate of patients with gastric cardiac cancer in the low group was significantly lower as compared to those in the high group （25.0% vs. 84.6%, P = 0.004）. Conclusions BMI dose not generally play a role in short-term outcomes and long-term survival of the gastric cancer patients. Nutritional improvement and body weight maintenance may be beneficial to low BMI patients, especially those with gastric cardiac cancer.
出处
《中华胃肠外科杂志》
CAS
CSCD
北大核心
2016年第3期296-299,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
胃肿瘤
体质指数
临床结局
预后
Stomach neoplasms
Body mass index
Clinical outcomes
Prognosis
