術前炎癥和營養預后指數與結直腸癌近期療效_《中國普外基礎與臨床雜志》

作者：

劉丹 ¹ , 汪曉東 ² , 鄧磊 ¹ , 呂東昊 ¹ , 董慧 ¹ , 牛潔 ¹ , 納飛飛 ¹ , 李立 ²

1.四川大學華西臨床醫學院/華西醫院MCQ團隊(成都 610041);;
2.四川大學華西醫院胃腸外科中心(成都 610041);

關鍵詞：

結直腸癌炎癥和營養預后指數術前評估預后

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目的探討結直腸癌患者術前炎癥和營養預后指數（prognostic inflammatory and nutritional index，PINI）水平與近期療效的關系。方法前瞻性納入2009年4~6月期間經病理檢查診斷為結直腸癌的住院患者。所有患者均于術前3 d測定血清α1-酸性糖蛋白、C-反應蛋白、白蛋白和前白蛋白水平，并以此計算術前PINI值。分析術前PINI水平與患者病理分期、術后并發癥、生活質量及復發轉移的關系。結果本研究共納入結直腸癌患者38例，均接受了根治性手術治療，術前PINI水平平均為2.17±1.27。術前PINI水平與病理TNM分期及M分期有關： Ⅳ期患者的PINI水平明顯高于Ⅰ、Ⅱ及Ⅲ期（P＜0.001），M1期患者的PINI水平亦明顯高于M0期（P＜0.001）。術前PINI水平與患者術后并發癥的發生無關（P gt;0.05）。術前PINI水平與患者術后的厭食情況、飲食總體情況及生存質量的總體評估水平有關：飲食不正常者或有厭食情況者，其PINI水平明顯高于飲食正常者(P=0.020)或無厭食情況者(P=0.020)；生存質量“差”者，其PINI水平明顯高于生存質量“好”(P=0.020)及“一般”(P=0.025)者。結論術前PINI可以作為結直腸癌患者短期預后的評估指標之一。

引用本文： 劉丹,汪曉東,鄧磊,呂東昊,董慧,牛潔,納飛飛,李立. 術前炎癥和營養預后指數與結直腸癌近期療效. 中國普外基礎與臨床雜志, 2009, 16(11): 934-938. doi: 復制

1.	Walsh D, Mahmoud F, Barna B. Assessment of nutritional status and prognosis in advanced cancer: interleukin-6, C-reactive protein, and the prognostic and inflammatory nutritional index [Ｊ]. Support Care Cancer, 2003; 11(1): 60-62.
2.	Ingenbleek Y, Carpentier YA. A prognostic inflammatory and nutritional index scoring critically ill patients [Ｊ]. Int J Vitam Nutr Res， 1985; 55(1): 91-101.
3.	Ishizuka M, Nagata H, Takagi K, et al. Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer [Ｊ]. Ann Surg, 2007; 246(6): 1047-1051.
4.	Read JA, Choy ST, Beale PJ, et al. Evaluation of nutritional and inflammatory status of advanced colorectal cancer patients and its correlation with survival [Ｊ]. Nutr Cancer, 2006; 55(1): 78-85.
5.	汪曉東, 馮碩, 游小林, 等. 結直腸腫瘤多學科協作診治模式下的隨訪體系建設 [Ｊ]. 中國普外基礎與臨床雜志, 2007; 14(6): 709-712.
6.	Shunyakov L, Ryan CK, Sahasrabudhe DM, et al. The influence of host response on colorectal cancer prognosis [Ｊ]. Clin Colorectal Cancer, 2004; 4(1): 38-45.
7.	Scott HR, McMillan DC, Forrest LM, et al. The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer [Ｊ]. Br J Cancer, 2002; 87(3): 264-267.
8.	Scott HR, McMillan DC, Brown DJ, et al. A prospective st-udy of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer [Ｊ]. Lung Cancer, 2003; 40(3): 295-299.
9.	Copeland EM 3rd, Daly JM, Ota DM, et al. Nutrition, cancer, and intravenous hyperalimentation [Ｊ]. Cancer, 1979; 43(5 Suppl): 2108-2116.
10.	Ravasco P, Monteiro-Grillo I, Vidal PM, et al. Dietary co-unseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy [Ｊ]. J Clin Oncol, 2005; 23(7): 1431-1438.
11.	Small W, Carrara R, Danford L, et al. Quality of life and nutrition in the patient with cancer [Ｊ]. Oncology, 2002; 17(suppl): 13-14.
12.	Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition [Ｊ]. Eur J Oncol Nurs, 2005; 9 Suppl 2: S51-S63.
13.	McMillan DC, Wotherspoon HA, Fearon KC, et al. A prospective study of tumor recurrence and the acute-phase response after apparently curative colorectal cancer surgery [Ｊ]. Am J Surg, 1995; 170(4): 319-322.
14.	Dalgleish AG, O’Byrne KJ. Chronic immune activation and inflammation in the pathogenesis of AIDS and cancer [Ｊ]. Adv Cancer Res, 2002; 84: 231-276.
15.	Shunyakov L, Ryan CK, Sahasrabudhe DM, et al. The influence of host response on colorectal cancer prognosis [Ｊ]. Clin Colorectal Cancer, 2004; 4(1): 38-45.
16.	Heriot AG, Marriott JB, Cookson S, et al. Reduction in cytokine production in colorectal cancer patients: association with stage and reversal by resection [Ｊ]. Br J Cancer, 2000; 82(5): 1009-1012.
17.	Shiu YC, Lin JK, Huang CJ, et al. Is C-reactive protein a prognostic factor of colorectal cancer? [Ｊ]. Dis Colon Rectum, 2008, 51(4): 443-449.
18.	Glojnaric＇ I, Casl MT, Simic＇ D, et al. Serum amyloid A protein (SAA) in colorectal carcinoma [Ｊ]. Clin Chem Lab Med, 2001; 39(2): 129-133.
19.	呂東昊, 高強, 汪曉東, 等. 多層螺旋CT聯合不同炎性反應指標對直腸癌外科決策的隨機對照研究 [Ｊ]. 中國普外基礎與臨床雜志, 2009； 16(10): 851-855.
20.	汪曉東, 鄧磊, 秦昌龍, 等. 術前血清淀粉樣蛋白A水平對低位局部進展直腸癌手術方案選擇的價值 [Ｊ]. 中國普外基礎與臨床雜志, 2009； 16(8): 667-670.
21.	汪曉東, 鄧磊, 呂東昊, 等. 結直腸癌患者術前SAA、CRP、CEA和CA19-9水平的臨床診斷價值 [Ｊ]. 四川醫學, 2009; 30(3): 340-342.
22.	汪曉東, 呂東昊, 高命, 等. 結直腸癌患者術前血清CRP與SAA檢測的意義 [Ｊ]. 中國腫瘤, 2009; 18(5): 416-419.
23.	Mazhar D, Ngan S. C-reactive protein and colorectal cancer [Ｊ]. QJM, 2006; 99(8): 555-559.
24.	Nielsen HJ, Christensen IJ, Srensen S, et al. Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group [Ｊ]. Ann Surg Oncol, 2000; 7(8): 617-623.
25.	Staib L, Link KH, Blatz A, et al. Surgery of colorectal cancer: surgical morbidity and five- and ten-year results in 2 400 patients-monoinstitutional experience [Ｊ]. World J Surg, 2002; 26(1): 59-66.
26.	Ouellette JR, Small DG, Termuhlen PM. Evaluation of Ch-arlson-Age Comorbidity Index as predictor of morbidity and mortality in patients with colorectal carcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(8): 1061-1067.
27.	Alvarez JA, Baldonedo RF, Bear IG, et al. Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma [Ｊ]. Am J Surg, 2005; 190(3): 376-382.
28.	Tsukada K, Miyazaki T, Kato H, et al. Body fat accumulation and postoperative complications after abdominal surgery [Ｊ]. Am Surg, 2004; 70(4): 347-351.
29.	Marusch F, Koch A, Schmidt U, et al. The impact of the risk factor “age” on the early postoperative results of surgery for colorectal carcinoma and its significance for perioperative management [Ｊ]. World J Surg, 2005; 29(8): 1013-1021; discussion 1021-1022.
30.	Mills PJ, Parker B, Dimsdale JE, et al. The relationship between fatigue and quality of life and inflammation during anthracycline-based chemotherapy in breast cancer [Ｊ]. Biol Psychol, 2005; 69(1): 85-96.

1. Walsh D, Mahmoud F, Barna B. Assessment of nutritional status and prognosis in advanced cancer: interleukin-6, C-reactive protein, and the prognostic and inflammatory nutritional index [Ｊ]. Support Care Cancer, 2003; 11(1): 60-62.
2. Ingenbleek Y, Carpentier YA. A prognostic inflammatory and nutritional index scoring critically ill patients [Ｊ]. Int J Vitam Nutr Res， 1985; 55(1): 91-101.
3. Ishizuka M, Nagata H, Takagi K, et al. Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer [Ｊ]. Ann Surg, 2007; 246(6): 1047-1051.
4. Read JA, Choy ST, Beale PJ, et al. Evaluation of nutritional and inflammatory status of advanced colorectal cancer patients and its correlation with survival [Ｊ]. Nutr Cancer, 2006; 55(1): 78-85.
5. 汪曉東, 馮碩, 游小林, 等. 結直腸腫瘤多學科協作診治模式下的隨訪體系建設 [Ｊ]. 中國普外基礎與臨床雜志, 2007; 14(6): 709-712.
6. Shunyakov L, Ryan CK, Sahasrabudhe DM, et al. The influence of host response on colorectal cancer prognosis [Ｊ]. Clin Colorectal Cancer, 2004; 4(1): 38-45.
7. Scott HR, McMillan DC, Forrest LM, et al. The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer [Ｊ]. Br J Cancer, 2002; 87(3): 264-267.
8. Scott HR, McMillan DC, Brown DJ, et al. A prospective st-udy of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer [Ｊ]. Lung Cancer, 2003; 40(3): 295-299.
9. Copeland EM 3rd, Daly JM, Ota DM, et al. Nutrition, cancer, and intravenous hyperalimentation [Ｊ]. Cancer, 1979; 43(5 Suppl): 2108-2116.
10. Ravasco P, Monteiro-Grillo I, Vidal PM, et al. Dietary co-unseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy [Ｊ]. J Clin Oncol, 2005; 23(7): 1431-1438.
11. Small W, Carrara R, Danford L, et al. Quality of life and nutrition in the patient with cancer [Ｊ]. Oncology, 2002; 17(suppl): 13-14.
12. Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition [Ｊ]. Eur J Oncol Nurs, 2005; 9 Suppl 2: S51-S63.
13. McMillan DC, Wotherspoon HA, Fearon KC, et al. A prospective study of tumor recurrence and the acute-phase response after apparently curative colorectal cancer surgery [Ｊ]. Am J Surg, 1995; 170(4): 319-322.
14. Dalgleish AG, O’Byrne KJ. Chronic immune activation and inflammation in the pathogenesis of AIDS and cancer [Ｊ]. Adv Cancer Res, 2002; 84: 231-276.
15. Shunyakov L, Ryan CK, Sahasrabudhe DM, et al. The influence of host response on colorectal cancer prognosis [Ｊ]. Clin Colorectal Cancer, 2004; 4(1): 38-45.
16. Heriot AG, Marriott JB, Cookson S, et al. Reduction in cytokine production in colorectal cancer patients: association with stage and reversal by resection [Ｊ]. Br J Cancer, 2000; 82(5): 1009-1012.
17. Shiu YC, Lin JK, Huang CJ, et al. Is C-reactive protein a prognostic factor of colorectal cancer? [Ｊ]. Dis Colon Rectum, 2008, 51(4): 443-449.
18. Glojnaric＇ I, Casl MT, Simic＇ D, et al. Serum amyloid A protein (SAA) in colorectal carcinoma [Ｊ]. Clin Chem Lab Med, 2001; 39(2): 129-133.
19. 呂東昊, 高強, 汪曉東, 等. 多層螺旋CT聯合不同炎性反應指標對直腸癌外科決策的隨機對照研究 [Ｊ]. 中國普外基礎與臨床雜志, 2009； 16(10): 851-855.
20. 汪曉東, 鄧磊, 秦昌龍, 等. 術前血清淀粉樣蛋白A水平對低位局部進展直腸癌手術方案選擇的價值 [Ｊ]. 中國普外基礎與臨床雜志, 2009； 16(8): 667-670.
21. 汪曉東, 鄧磊, 呂東昊, 等. 結直腸癌患者術前SAA、CRP、CEA和CA19-9水平的臨床診斷價值 [Ｊ]. 四川醫學, 2009; 30(3): 340-342.
22. 汪曉東, 呂東昊, 高命, 等. 結直腸癌患者術前血清CRP與SAA檢測的意義 [Ｊ]. 中國腫瘤, 2009; 18(5): 416-419.
23. Mazhar D, Ngan S. C-reactive protein and colorectal cancer [Ｊ]. QJM, 2006; 99(8): 555-559.
24. Nielsen HJ, Christensen IJ, Srensen S, et al. Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group [Ｊ]. Ann Surg Oncol, 2000; 7(8): 617-623.
25. Staib L, Link KH, Blatz A, et al. Surgery of colorectal cancer: surgical morbidity and five- and ten-year results in 2 400 patients-monoinstitutional experience [Ｊ]. World J Surg, 2002; 26(1): 59-66.
26. Ouellette JR, Small DG, Termuhlen PM. Evaluation of Ch-arlson-Age Comorbidity Index as predictor of morbidity and mortality in patients with colorectal carcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(8): 1061-1067.
27. Alvarez JA, Baldonedo RF, Bear IG, et al. Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma [Ｊ]. Am J Surg, 2005; 190(3): 376-382.
28. Tsukada K, Miyazaki T, Kato H, et al. Body fat accumulation and postoperative complications after abdominal surgery [Ｊ]. Am Surg, 2004; 70(4): 347-351.
29. Marusch F, Koch A, Schmidt U, et al. The impact of the risk factor “age” on the early postoperative results of surgery for colorectal carcinoma and its significance for perioperative management [Ｊ]. World J Surg, 2005; 29(8): 1013-1021; discussion 1021-1022.
30. Mills PJ, Parker B, Dimsdale JE, et al. The relationship between fatigue and quality of life and inflammation during anthracycline-based chemotherapy in breast cancer [Ｊ]. Biol Psychol, 2005; 69(1): 85-96.

《中國普外基礎與臨床雜志》

術前炎癥和營養預后指數與結直腸癌近期療效

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《中國普外基礎與臨床雜志》

術前炎癥和營養預后指數與結直腸癌近期療效

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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