目的 探究营养不良评定标准全球领导人共识(GLIM) 、欧洲肠外肠内营养学会 2015 年营养不良专家共识(ESPEN 2015)及患者主观整体评估(PG-SGA)对食管癌术后并发症的预测价值。 方法 选取 2019 年 1 月至 2023 年 3 月武汉 市中心医院收治的食管癌患者 128 例临床资料开展回顾性分析,根据患者术后并发症发生情况将其分为并发症组( 49 例) 与无并发症组(79 例) 。 比较 GLIM、ESPEN 2015 及 PG-SGA 评估 128 例患者术前营养状况,分析术后并发症影响因素,并 采用受试者操作特征(ROC)曲线分析获取 GLIM、ESPEN 2015、PG-SGA 与联合数据预测术后并发症发生效能。 结果 GLIM 评估患者存在 33 例营养不良、ESPEN 2015 评估患者存在 18 例营养不良,PG-SGA 评估患者存在 19 例营养不良,GLIM 评 估营养不良发生率高于 ESPEN 2015 评估、PG-SGA 评估(P<0. 05) 。 二元 Logistic 回归分析显示,TNM 分期(Ⅲ ~ Ⅳ期) 、 GLIM(营养不良) 、ESPEN 2015(营养不良) 、PG-SGA(营养不良)均是食管癌患者术后并发症的独立危险因素(P<0. 05) 。 TNM 分期Ⅲ~ Ⅳ期患者 GLIM、ESPEN 2015、PG-SGA 评估营养不良患者所占比例要高于 TNM 分期Ⅰ ~ Ⅱ期患者。 采用 ROC 曲线获取 GLIM、ESPEN 2015、PG-SGA 与三者联合预测术后并发症发生的曲线下面积分别为 0. 645、0. 568、0. 578、 0. 716(P<0. 05) 。 结论 食管癌患者术前多存在营养不良风险,且营养不良与食管癌 TNM 分期存在密切相关,为术后并发 症发生的危险因素。 GLIM、ESPEN 2015 及 PG-SGA 均可用于评估食管癌术前营养不良状况,且三者联合预测食管癌术后 并发症发生具有较好效能。

Objective To explore the predictive value of the global leadership initiative on malnutrition GLIM the European Society for Parenteral Enteral Nutrition Expert Consensus on Malnutrition 2015 ESPEN 2015 and patient-generated subjective global assessment PG- SGA in analyzing postoperative complications of esophageal cancer. Method The clinical data of 128 cases of oesophageal cancer patients admitted to Wuhan Central Hospital from January 2019 to March 2023 were selected and the patients were divided into the complication group 49 cases and the no-complication group 79 cases according to the occurrence of postoperative complications. GLIM ESPEN 2015 and PG- SGA were compared to assess the preoperative nutritional status of 128 patients to analyze the factors affecting postoperative complications and ROC analysis was used to obtain the efficacy of GLIM ESPEN 2015 PG-SGA with the combined data to predict the occurrence of postoperative complications. Result There were 33 cases of malnutrition in GLIM- assessed patients 18 cases of malnutrition in ESPEN 2015 - assessed patients and 19 cases of malnutrition in PG - SGA-assessed patients and the incidence of malnutrition was higher in the GLIM-assessed patients than in the ESPEN 2015-assessed patients and the PG-SGA-assessed patients P<0. 05 . Binary logistic regression analysis showed that TNM staging stage Ⅲ-Ⅳ GLIM malnutrition ESPEN 2015 malnutrition and PG-SGA malnutrition were all risk factors for postoperative complications in patients with esophageal cancer P < 0. 05 . The proportion of patients with malnutrition assessed by GLIM ESPEN 2015 and PG-SGA in TNM stage Ⅲ - Ⅳ was higher than that in TNM stage Ⅰ- Ⅱ. The presence of TNM staging and malnutrition assessed by GLIM ESPEN 2015 and PG-SGA was correlation P<0. 05 . ROC analysis was used to obtain the AUC of GLIM ESPEN 2015 PG- SGA and combined data to predict the occurrence of postoperative complications were 0. 645 0. 568 0. 578 and 0. 716 respectively P<0. 05 . Conclusion Patients with esophageal cancer are mostly at risk of malnutrition before surgery and malnutrition is closely related to the clinical characteristics of esophageal cancer patients which is an independent risk factor for the occurrence of postoperative complications. GLIM ESPEN 2015 and PG - SGA can be used to assess the status of preoperative malnutrition in esophageal cancer and the combination of the three predicts the occurrence of postoperative complications in esophageal cancer with a good efficacy.