目的 探讨控制营养状态(CONUT)评分和相关指标在骨肉瘤患者预后预测中的应用价值。 方法 收集 2000 年至 2018 年宜宾市第一人民医院和宜宾市第二人民医院骨肉瘤患者的病历资料,随访患者临床结局,采用受试者操作特征(ROC) 曲线分析全身免疫炎症指数(SII)和 CONUT 评分预测患者预后的截止点,采用 Kaplan-Meier 曲线、Log-rank 检验和 Cox 回归 分析患者预后的影响因素。 结果 92 例患者中位随访时间 58(37,66)个月,中位生存时间 50(23,61)个月,患者 5 年生存率为 51. 09%(95%CI = 40. 31% ~ 61. 87%)。 SII 和 CONUT 的 ROC 曲线下面积分别为 0. 726 和 0. 951,最佳截止点为 671. 66×10 9 / L 和 1. 5 分(P<0. 01)。 Cox 回归显示:诊断时有转移、T 分期 3 ~ 4 期和 Enneking 分期Ⅲ期是影响患者预后的危险因素,其 HR(95%CI)分别为 2. 751(1. 166~ 6. 491)、2. 230 (1. 033~ 4. 815)和 4. 889 (1. 094~ 21. 854),CONUT≥2 分则是影响患者预后的保护因素,其 HR(95%CI)为 0. 065(0. 023~ 0. 184)(P<0. 05)。 结论 CONUT 评分、T 分期、诊断时有无转移和 Enneking 分期与骨肉瘤患者预后有关,而 SII 与患者临床结局无关。

Objective To discuss the value of controlling nutritional status score CONUT and related indicators in predicting the prognosis of osteosarcoma patients. Method From 2000 to 2018 medical records of 92 patients with osteosarcoma were collected from the First Peoples' Hospital of Yibin and the Second Hospital of Yibin and followed up the clinical outcomes of patients until Dec. 30 2022. ROC curve analysis was used to calculate the cut-off values of SII and CONUT for prognosis prediction Kaplan-Meier method Log-rank test and Cox regression analysis was used to draw survival curves and analyze the influencing factors of prognosis among osteosarcoma patients. Result The medium follow-up time of 92 patients was 58 37 66 months with an medium survival time of 50 23 61 months. The 5-year survival rate was 51. 09% 95%CI = 40. 31%-61. 87% . The area under the ROC curves AUC of SII and CONUT were 0. 726 and 0. 951 respectively with the optimal cut-off values of 671. 66×10 9 / L and 1. 5 points P<0. 01 . Cox regression showed that whether metastasis when diagnosis T stage 3 to 4 and Enneking stage Ⅲ are risk factors of prognosis for patients with HR 95% CI of 2. 751 1. 166 - 6. 491 2. 230 1. 033 - 4. 815 and 4. 889 1. 094 - 21. 854 respectively. CONUT≥2 points are protective factors of prognosis with HR 95%CI of 0. 065 0. 023-0. 184 P<0. 05 . Conclusion CONUT score T stage whether metastasis when diagnosis and Enneking stage are related to the prognosis of osteosarcoma patients while SII is not related to the clinical outcomes of patients with osteosarcoma.