摘要
目的 观察基于全身炎症反应的GPS评分在胃癌患者营养及体力状态评估中的应用价值。方法 回顾性收集2013年1月至2014年3月在我院住院、有人体成分测量及血液学数据的43例胃癌患者，从营养状态、体力状态及人体成分测量三方面分析GPS评分与患者营养及体力状态的关系。结果 43例患者中男性18例，女性25例，GPS评分为0分、1分和2分者分别为27例、14例和2例。GPS评分与NRS 2002评分及PG-SGA评分未发现显著的统计学关系，但与部分营养指标有关，GPS评分≥1分者前白蛋白水平较GPS评分为0分者显著降低（P=0.048）；淋巴细胞计数有降低趋势（P=0.078）。分析GPS与体力状态的关系发现，GPS评分≥1分者Karnofsky功能状态评分更低（P=0.015），与生活质量评分有相关性趋势（P=0.076）。分析GPS评分与人体成分测量的关系发现，GPS评分≥1分者上臂中点周径明显小于GPS评分0分者（P=0.042），双侧小腿最大周径也明显减少（左右侧P值分别为0.023和0.03）。上臂肌肉周径、三头肌皮褶厚度及非利手握力均有减少，但未达到显著的统计学差异。结论 基于全身炎症反应的GPS评分与胃癌患者的部分营养指标及体力状态有关，因此有望成为胃癌患者营养及体力状态评估的简化替代指标。
Abstract
To observe the value of Glasgow prognostic score (GPS) based on systemic inflammatory response in evaluating nutritional status and performance status in patients with gastric cancer. Methods 43 patients with gastric cancer hospitalized in our hospital from January 2013 to March 2014 with body composition measurement and hematological data were collected. The relationship between GPS score and nutritional， performance status were analyzed. Results In 43 gastric cancer patients， there were 18 males and 25 females. There were 27， 14 and 2 patients with GPS scores of 0， 1 and 2， respectively. It was found there was no significant statistical relationship between GPS score with NRS 2002 (nutrition risk screening， NRS 2002) score and PG-SGA (patient-generated subjective global assessment) score. The serum level of prealbumin in patients with GPS score ≥1 was significantly lower than that of patients with GPS score 0 (P=0.048)， and there was a trend to decline in blood lymphocyte count (P=0.078). The KPS score of patients with GPS score ≥ 1 was lower (P=0.015)， and there was a trend of correlation between GPS and quality of life (P=0.076). In analysis involving body composition measurement， the mid-upper arm circumference in patients with GPS score ≥1 turned to be significantly smaller than that of GPS score 0 (P=0.042). The maximum circumferences of both legs were also obviously smaller in patients with GPS ≥1 than that of GPS 0. The upper arm muscle circumference， triceps skin fold thickness and non-dominant hand grip strength were all reduced， but no significant statistical difference was found between patients with GPS ≥1 and GPS 0. Conclusion GPS score is based on systemic inflammatory response and related to parts of nutritional indicators and performance status of gastric cancer patients. It is a promising simplified alternative index for nutritional and performance status assessment of gastric cancer patients.
关键词
Glasgow预后评分 /
胃癌 /
营养状态 /
体力状态
Key words
Glasgow prognostic score /
Gastric cancer /
Nutritional status /
Performance status
葛少华，陈幸运，张海洋，宁涛，李鸿立，巴一.
Glasgow预后评分与胃癌患者营养及体力状态关系的研究[J]. 肿瘤代谢与营养电子杂志. 2019, 6(2): 212-215 https://doi.org/10.16689/j.cnki.cn11-9349/r.2019.02.011
GE Shao-hua， CHEN Xing-yun， ZHANG Hai-yang， NING Tao， LI Hong-li， BA Yi.
Study on the relationship between Glasgow prognostic score and nutritional， physical status in patients with gastric cancer[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2019, 6(2): 212-215 https://doi.org/10.16689/j.cnki.cn11-9349/r.2019.02.011
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参考文献
1.黄道来，吴向华，陈俊强，等. NRS 2002、PG-SGA、BMI、TF 在胃癌营养筛查与评估中的作用.肿瘤代谢与营养电子杂志.2017；4(3):317-321.
2.Ryu SW， Kim IH. Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol. 2010；16(26):3310-3317.
3.Fukuda Y， Yamamoto K， Hirao M， et al.Prevalence of malnutrition among gastric cancer patients undergoing gastrectomy and optimal preoperative nutritional support for preventing surgical site infections.Ann Surg Oncol. 2015；22 Suppl 3:S778-785.
4.Zablocka-Slowinska KA， Kosacka M， Porebska I， et al.The usefulness of routinely used malnutrition screening tools in predicting anemia in lung cancer patients. Adv Clin Exp Med. 2017；26(9):1383-1389.
5.Fujiya K， Kawamura T， Omae K， et al.Impact of malnutrition after gastrectomy for gastric cancer on long-term survival.Ann Surg Oncol. 2018；25(4):974-983.
6.Zhang CX， Wang SY， Chen SQ， et al.Association between pretreatment Glasgow prognostic score and gastric cancer survival and clinicopathological features:a meta-analysis. Onco Targets Ther. 2016；9:3883-3891.
7.Forrest LM， McMillan DC， McArdle CS， et al. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer.Br J Cancer. 2003；89(6):1028-1030.
8.Roncolato FT， Berton-Rigaud D， O’Connell R， et al. Validation of the modified Glasgow prognostic score (mGPS) in recurrent ovarian cancer (ROC) - analysis of patients enrolled in the GCIG Symptom Benefit Study (SBS).Gynecol Oncol. 2018；148(1):36-41.
9.Okano N， Kasuga A， Kawai K， et al. The modified Glasgow prognostic score in patients with gemcitabine-refractory biliary tract cancer. Anticancer Res. 2018；38(3):1755-1761.
10.Jin J， Hu K， Zhou Y， et al. Prognostic value of the Glasgow prognostic score in lung cancer: evidence from 10 studies.Int J Biol Markers. 2018；33(2):201-207.
11.Minami S， Ogata Y， Ihara S， et al. Pretreatment Glasgow prognostic score and prognostic nutritional index predict overall survival of patients with advanced small cell lung cancer. Lung Cancer (Auckl). 2017；8:249-257.
12.Liu Y， He X， Pan J， et al. Prognostic role of Glasgow prognostic score in patients with colorectal cancer: evidence from population studies. Sci Rep. 2017；7(1):6144.
13.McMillan DC. The systemic inflammation-based Glasgow prognostic score: a decade of experience in patients with cancer. Cancer Treat Rev. 2013；39(5):534-540.
14.Zhu J， Wang H， Liu CC， et al. The Glasgow prognostic score (GPS) is a novel prognostic indicator in advanced epithelial ovarian cancer: a multicenter retrospective study. J Cancer Res Clin Oncol. 2016；142(11):2339-2345.
15.Yuan SQ， Nie RC， Chen YM， et al. Glasgow prognostic score is superior to ECOG PS as a prognostic factor in patients with gastric cancer with peritoneal seeding. Oncol Lett. 2018；15(4):4193-4200.
16.Zou Z， Zhao L， Su S， et al. The plasma levels of 12 cytokines and growth factors in patients with gastric cancer. Medicine (Baltimore). 2018；97(19):e0413.
17.Mauricio SF， da Silva JB， Bering T， et al. Relationship between nutritional status and the Glasgow prognostic score in patients with colorectal cancer. Nutrition. 2013；29(4):625-629.
18.Matsunaga T， Miyata H， Sugimura K， et al. Prognostic significance of sarcopenia and systemic inflammatory response in patients with esophageal cancer. Anticancer Res. 2019；39(1):449-458.
19.余静，周福祥.肌肉减少症与代谢综合征关系的研究进展. 肿瘤代谢与营养电子杂志. 2018；5(3):324-327.
20.Feliciano EMC， Kroenke CH， Meyerhardt JA， et al. Association of systemic inflammation and sarcopenia with survival in nonmetastatic colorectal cancer: results from the C SCANS study. JAMA Oncol. 2017；3(12):e172319.
基金
国家自然科学基金资助项目（81772629）
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