摘要
探讨体质指数(BMI)与胃癌患者的临床病理特征和预后的关系。方法回顾性分析788例进展期胃癌患者的临床资料。根据WHO的体重标准分组,BMI<18.5 kg/m^2为低重组,18.5 kg/m^2≤BMI<25.0 kg/m^2为正常组,BMI≥25.0 kg/m^2为超重组。低重组127例,正常组540例,超重组121例。分析不同BMI分组与患者临床病理特征的关系,采用Cox多因素回归模型分析影响患者预后的独立因素。结果788例患者BMI的平均值为21.70 kg/m^2。BMI与肿瘤浸润深度、肿瘤最大直径、中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值(PLR)均有关(均P<0.05);BMI与性别、年龄、吸烟、饮酒、肿瘤TNM分期、淋巴结转移和组织学分型均无关(均P>0.05)。BMI与前白蛋白、预后营养指数、总蛋白、白蛋白和血红蛋白水平均有关(均P<0.05)。BMI与术中出血量、手术时间、淋巴结切除数目、淋巴结转移数目和淋巴结转移率均有关(均P<0.05)。全组患者的中位生存时间为35.3个月;低重组、正常组和超重组患者的中位生存时间分别为21.0、26.3和31.2个月,差异有统计学意义(P<0.001)。Cox多因素分析显示,TNM分期、肿瘤浸润深度、淋巴结转移、PLR和BMI是影响胃癌患者预后的独立危险因素(均P<0.05)。结论BMI与胃癌患者营养状态、术中出血量、手术时间和淋巴结转移率有关。BMI为胃癌患者预后的独立危险因素,低体重患者的总生存时间短于正常体重和超重患者。
Objective To investigate the relationship between body mass index(BMI)and clinicopathological characteristics and prognosis of gastric cancer patients.Methods The clinical data of 788 patients with advanced gastric cancer were retrospectively analyzed.According to WHO weight standard,BMI<18.5 kg/m^2 was the low weight group,BMI 18.5~<25.0 kg/m^2 was the normal weight group,BMI≥25.0 kg/m^2 was the overweight group.The low weight group included 127 cases,the normal weight group included 540 cases and the overweight group included 121 cases.The relationship between different BMI groups and clinicopathological characteristics of patients was analyzed.Cox multivariate regression model was used to analyze the independent factor of the prognosis of patients.Results The average BMI of 788 patients was 21.70 kg/m^2.The patients′BMI was significantly correlated with depth of invasion,maximum diameter of tumors,neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)(all P<0.05).BMI was marginally correlated with gender,age,smoking,alcohol consumption,TNM stage,lymph node metastasis and histological type(all P>0.05).Furthermore,BMI was significantly correlated with prealbumin,prognostic nutritional index,total protein,albumin and hemoglobin levels(all P<0.05).BMI was also significantly correlated with intraoperative bleeding volume,operation time,number of lymph node resection,number of lymph node metastasis and lymph node metastatic ratio(all P<0.05).The median survival time of the entire group was 35.3 months.The median survival time of patients in low weight group,normal weight group,and overweight group was 21.0 months,26.3 months,and 31.2 months,respectively,the differences were statistically significant(P<0.001).Cox multivariate analysis showed that TNM stage,depth of tumor invasion,lymph node metastasis,PLR and BMI were independent risk factors of the prognosis of patients with gastric cancer(all P<0.05).Conclusions BMI is associated with the nutritional status,intraoperative blood loss,operative
作者
韩帮岭
汪亦民
薛英威
Han Bangling;Wang Yimin;Xue Yingwei(Department of Gastrointestinal Surgery,Harbin Medical University Cancer Hospital,Harbin 150081,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2019年第7期527-532,共6页
Chinese Journal of Oncology
基金
哈尔滨市科技局应用技术研究与开发项目(2017RAXXJ054)
哈尔滨医科大学附属肿瘤医院优秀学科(Nn10计划)培育项目(Nn10PY2017-03).
关键词
胃肿瘤
体质指数
生存分析
预后
Gastric neoplasms
Body mass index
Survival analysis
Prognosis
