Comparative study of prognostic nutritional index and patient-generated subjective global assessment in perioperative nutritional prediction in patients with esophageal cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Hong , XIE Qin , DENG Mingzhen , MIAO Yan ,  HAN Yongtao

Division of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Cancer Hospital Affiliated to School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P.R.China;

Corresponding author：

HAN Yongtao, Email: hanyongt@aliyun.com

Keywords：

Esophageal cancer; perioperative period; prognosis nutritional index; patient-generated subjective global assessment; nutritional status

DOI：

10.7507/1007-4848.201905056

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the prognostic value and consistency of prognostic nutritional index (PNI) and patient-generated subjective global assessment (PG-SGA) in perioperative nutritional status of patients with esophageal cancer.Methods Clinical data of 224 patients, including 186 males and 38 females with an average age of 63.08±8.42 years, who underwent esophageal cancer surgery in our hospital from November 2017 to August 2018 were retrospectively reviewed. The PNI was calculated according to the results of the first time blood and biochemical tests, and the PG-SGA assessment was also performed. According to the PNI value, the patients were divided into a good nutrition group (PNI≥45, 60 patients) and a malnutrition group (PNI<45, 164 patients). According to the PG-SGA score, the patients were divided into a good nutrition group (PG-SGA<4, 75 patients) and a malnutrition group (PG-SGA≥4, 149 patients). Nutrition-related haematological indexes and body mass index (BMI) were compared between the two groups, and the consistency of PNI and PG-SGA for nutritional assessment was analyzed.Results The nutrition-related haematological indexes in different PNI groups were statistically different in the perioperative period (P<0.01). The longitudinal changes of prealbumin in patients of different PG-SGA groups were statistically different (P<0.05); the BMI of patients in different PG-SGA groups was statistically different in the perioperative period (P<0.01). The Kappa coefficient of the two indicators was 0.589 (P<0.001).Conclusion Both PNI and PG-SGA can predict the nutritional risk of patients with esophageal cancer to some extent. PNI is an objective monitoring indicator, and PG-SGA is a subjective evaluation indicator, the combined use of which can more comprehensively reflect and predict the nutritional status of patients, and provide an important reference to the development of individualized nutrition support programs.

Citation： ZHOU Hong, XIE Qin, DENG Mingzhen, MIAO Yan, HAN Yongtao. Comparative study of prognostic nutritional index and patient-generated subjective global assessment in perioperative nutritional prediction in patients with esophageal cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(4): 436-440. doi: 10.7507/1007-4848.201905056 Copy

1.	王耀鹏, 徐林浩, 王清, 等. 食管癌患者术后早期肠内营养的临床研究. 中国胸心血管外科临床杂志, 2006, 13(2): 94-96.
2.	余帅, 王志刚, 黄敏乾, 等. 食管癌手术后肠内营养与肠外营养对肝、肾功能及胃肠功能影响的对比研究. 中国胸心血管外科临床杂志, 2014, 21(4): 498-502.
3.	孙志勇, 曹子昂, 叶清, 等. 术前运用 NRS2002 评估食管癌患者营养风险及临床结局的研究. 中国胸心血管外科临床杂志, 2015, 22(4): 323-326.
4.	黎介寿. 肿瘤营养学的兴起及临床应用. 肠外与肠内营养, 2004, 11(1): 1-2.
5.	Zhang L, Lu Y, Fang Y. Nutritional status and related factors of patients with advanced gastrointestinal cancer. Br J Nutr, 2014, 111(7): 1239-1244.
6.	中国营养学会. 国民营养计划(2017-2030 年). 营养学报, 2017, 39(4): 315-320, 312.
7.	Huhmann MB, August DA. Review of American Society for Parenteral and Enteral Nutrition (ASPEN) clinical guidelines for nutrition support in cancer patients: nutrition screening and assessment. Nutr Clin Pract, 2008, 23(2): 182-188.
8.	Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr, 2002, 56(8): 779-785.
9.	CSCO 肿瘤营养治疗专家委员会. 恶性肿瘤患者的营养治疗专家共识. 临床肿瘤学杂志, 2012, 17(1): 59-73.
10.	Buzby GP, Mullen JL, Matthews DC, et al. Prognostic nutritional index in gastrointestinal surgery. Am J Surg, 1980, 139(1): 160-167.
11.	Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi, 1984, 85(9): 1001-1005.
12.	Borda F, Miranda C, Borda A, et al. Relation between preoperative prognostic Onodera's Index and postsurgery complications in the R0 gastric carcinoma resection. An Sist Sanit Navar, 2017, 40(1): 67-75.
13.	Ottery FD. Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol, 1994, 21(6): 770-778.
14.	Gabrielson DK, Scaffidi D, Leung E, et al. Use of an abridged scored Patient-Generated Subjective Global Assessment (abPG-SGA) as a nutritional screening tool for cancer patients in an outpatient setting. Nutr Cancer, 2013, 65(2): 234-239.
15.	侯雷, 吕晓峰, 赵恩宏. 早期肠内营养在腹腔镜低位直肠癌术后患者中的应用效果及吻合口漏的影响因素分析. 解放军预防医学杂志, 2019, 37(3): 87-89.
16.	刘明勋, 朱青山. 食管癌 TNM 分期以外的预后因素分析. 实用医药杂志, 2014, 31(10): 897-900.
17.	d'Engremont C, Vernerey D, Pointet AL, et al. Additive value of pre-operative and one-month post-operative lymphocyte count for death-risk stratification in patients with resectable pancreatic cancer: a multicentric study. BMC Cancer, 2016, 16(1): 823.
18.	徐世斌, 徐美青, 孙效辉, 等. 预后营养指数与食管鳞癌患者术后并发症和远期预后的相关性研究. 中国肿瘤临床, 2018, 45(15): 789-794.
19.	李美端, 张娟, 杨胜生, 等. 营养预后指数评估术前营养状态对食管癌术后并发症的预测价值. 临床与病理杂志, 2018, 38(6): 1267-1273.
20.	方炎鑫, 张仁泉, 黄云龙, 等. 中性粒/淋巴细胞的比值和预后营养指数在食管鳞癌患者预后评估的应用. 安徽医科大学学报, 2018, 53(8): 1294-1298.
21.	Matsumoto H, Okamoto Y, Kawai A, et al. Prognosis prediction for postoperative esophageal cancer patients using Onodera's prognostic nutritional index. Nutr Cancer, 2017, 69(6): 849-854.
22.	Okadome K, Baba Y, Yagi T, et al. Prognostic nutritional index, tumor-infiltrating lymphocytes, and prognosis in patients with esophageal cancer [published online ahead of print, 2018 Oct 10]. Ann Surg, 2018. doi:10.1097/SLA.0000000000002985.
23.	Gu WS, Fang WZ, Liu CY, et al. Prognostic significance of combined pretreatment body mass index (BMI) and BMI loss in patients with esophageal cancer. Cancer Manag Res, 2019, 11: 3029-3041.
24.	孙方园, 张蓓蕾, 张燕忠. 进展期胃癌患者前白蛋白水平与 PG-SGA 评分相关性分析. 肿瘤代谢与营养电子杂志, 2016, 3(3): 170-173.
25.	徐东平, 齐玉梅, 张明, 等. 胃癌患者术前 PG-SGA 评分与人体成分的相关性. 海南医学, 2017, 28(16): 2622-2624.
26.	翟泽民. 消化道肿瘤患者术前 PG-SGA 评分与人体成分的相关性研究. 肿瘤代谢与营养电子杂志, 2016, 3(2): 114-117.
27.	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.

1. 王耀鹏, 徐林浩, 王清, 等. 食管癌患者术后早期肠内营养的临床研究. 中国胸心血管外科临床杂志, 2006, 13(2): 94-96.
2. 余帅, 王志刚, 黄敏乾, 等. 食管癌手术后肠内营养与肠外营养对肝、肾功能及胃肠功能影响的对比研究. 中国胸心血管外科临床杂志, 2014, 21(4): 498-502.
3. 孙志勇, 曹子昂, 叶清, 等. 术前运用 NRS2002 评估食管癌患者营养风险及临床结局的研究. 中国胸心血管外科临床杂志, 2015, 22(4): 323-326.
4. 黎介寿. 肿瘤营养学的兴起及临床应用. 肠外与肠内营养, 2004, 11(1): 1-2.
5. Zhang L, Lu Y, Fang Y. Nutritional status and related factors of patients with advanced gastrointestinal cancer. Br J Nutr, 2014, 111(7): 1239-1244.
6. 中国营养学会. 国民营养计划(2017-2030 年). 营养学报, 2017, 39(4): 315-320, 312.
7. Huhmann MB, August DA. Review of American Society for Parenteral and Enteral Nutrition (ASPEN) clinical guidelines for nutrition support in cancer patients: nutrition screening and assessment. Nutr Clin Pract, 2008, 23(2): 182-188.
8. Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr, 2002, 56(8): 779-785.
9. CSCO 肿瘤营养治疗专家委员会. 恶性肿瘤患者的营养治疗专家共识. 临床肿瘤学杂志, 2012, 17(1): 59-73.
10. Buzby GP, Mullen JL, Matthews DC, et al. Prognostic nutritional index in gastrointestinal surgery. Am J Surg, 1980, 139(1): 160-167.
11. Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi, 1984, 85(9): 1001-1005.
12. Borda F, Miranda C, Borda A, et al. Relation between preoperative prognostic Onodera's Index and postsurgery complications in the R0 gastric carcinoma resection. An Sist Sanit Navar, 2017, 40(1): 67-75.
13. Ottery FD. Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol, 1994, 21(6): 770-778.
14. Gabrielson DK, Scaffidi D, Leung E, et al. Use of an abridged scored Patient-Generated Subjective Global Assessment (abPG-SGA) as a nutritional screening tool for cancer patients in an outpatient setting. Nutr Cancer, 2013, 65(2): 234-239.
15. 侯雷, 吕晓峰, 赵恩宏. 早期肠内营养在腹腔镜低位直肠癌术后患者中的应用效果及吻合口漏的影响因素分析. 解放军预防医学杂志, 2019, 37(3): 87-89.
16. 刘明勋, 朱青山. 食管癌 TNM 分期以外的预后因素分析. 实用医药杂志, 2014, 31(10): 897-900.
17. d'Engremont C, Vernerey D, Pointet AL, et al. Additive value of pre-operative and one-month post-operative lymphocyte count for death-risk stratification in patients with resectable pancreatic cancer: a multicentric study. BMC Cancer, 2016, 16(1): 823.
18. 徐世斌, 徐美青, 孙效辉, 等. 预后营养指数与食管鳞癌患者术后并发症和远期预后的相关性研究. 中国肿瘤临床, 2018, 45(15): 789-794.
19. 李美端, 张娟, 杨胜生, 等. 营养预后指数评估术前营养状态对食管癌术后并发症的预测价值. 临床与病理杂志, 2018, 38(6): 1267-1273.
20. 方炎鑫, 张仁泉, 黄云龙, 等. 中性粒/淋巴细胞的比值和预后营养指数在食管鳞癌患者预后评估的应用. 安徽医科大学学报, 2018, 53(8): 1294-1298.
21. Matsumoto H, Okamoto Y, Kawai A, et al. Prognosis prediction for postoperative esophageal cancer patients using Onodera's prognostic nutritional index. Nutr Cancer, 2017, 69(6): 849-854.
22. Okadome K, Baba Y, Yagi T, et al. Prognostic nutritional index, tumor-infiltrating lymphocytes, and prognosis in patients with esophageal cancer [published online ahead of print, 2018 Oct 10]. Ann Surg, 2018. doi:10.1097/SLA.0000000000002985.
23. Gu WS, Fang WZ, Liu CY, et al. Prognostic significance of combined pretreatment body mass index (BMI) and BMI loss in patients with esophageal cancer. Cancer Manag Res, 2019, 11: 3029-3041.
24. 孙方园, 张蓓蕾, 张燕忠. 进展期胃癌患者前白蛋白水平与 PG-SGA 评分相关性分析. 肿瘤代谢与营养电子杂志, 2016, 3(3): 170-173.
25. 徐东平, 齐玉梅, 张明, 等. 胃癌患者术前 PG-SGA 评分与人体成分的相关性. 海南医学, 2017, 28(16): 2622-2624.
26. 翟泽民. 消化道肿瘤患者术前 PG-SGA 评分与人体成分的相关性研究. 肿瘤代谢与营养电子杂志, 2016, 3(2): 114-117.
27. 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.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Comparative study of prognostic nutritional index and patient-generated subjective global assessment in perioperative nutritional prediction in patients with esophageal cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content