摘要
目的探讨术前控制营养状态(CONUT)评分和相关炎症指标与脑胶质瘤患者临床预后的关系。方法回顾性分析2015~2020年宜宾市3所综合性医院收治的151例脑胶质瘤患者的病历资料,随访患者临床结局至2022年12月30日,用R语言绘制ROC曲线并计算相关指标的曲线下面积(AUC)和最佳截断值,用Kaplan-Meier法绘制生存曲线,Log-rank检验和Cox回归分析影响患者预后的相关因素。结果中位生存时间13(9,19)个月,随访期内死亡率66.9%,患者6个月和1年生存率分别为88.7%和53.6%。CONUT评分、中性粒细胞和淋巴细胞比值(NLR)、血小板和淋巴细胞比值(PLR)与淋巴细胞和单核细胞比值(LMR)用于患者预后预测的AUC分别为0.960、0.792、0.894和0.888,最佳截断值分别为2.5分、88.335、2.585和4.325。Cox回归分析显示:CONUT评分、NLR、WHO分级是患者预后的影响因素(P<0.05)。CONUT≥2.5分和<2.5分、NLR≥2.585和<2.585、WHO分级Ⅱ级、Ⅲ级和Ⅳ级的脑胶质瘤患者1年生存率分别为26.1%和92.1%、34.8%和83.1%及90.2%、55.2%和16.3%。结论脑胶质瘤患者预后不良,CONUT评分、NLR和WHO分级可能是患者预后的重要预测因素。
Objective To explore the relationship between preoperative controlling nutritional status(CONUT)score and rel-evant inflammatory markers and the clinical prognosis of patients with glioma.Methods A retrospective analysis was conducted on the medical records of 151 glioma patients admitted to our general hospitals in Yibin from 2015 to 2020.The clinical outcomes of patients were followed up until December 30,2022.The ROC curve was plotted using R language,and the area under the curve(AUC)and the optimal cut-off value were calculated.The survival curve was plotted using Kaplan-Meier method.Log-rank test and Cox regression analysis were used to identify the associated influencing factors of patient's survival.Results The median survival time was 13(9,19)months,and the mortality rate during the follow-up period was 66.9%.The 6-month and 1-year survival rates were 88.7%and 53.6%,respectively.The AUC of ROC curves of CONUT score,platelet to lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR),and lymphocyte to monocyte ratio(LMR)for predicting prognosis were 0.960,0.792,0.894,and 0.888,respectively.The optimal cut-off values were 2.5 points,88.335,2.585 and 4.325,respectively.Cox regression analysis showed that the CONUT score,NLR,and WHO grading were influencing factors for the prognosis of glioma patients.The 1-year survival rates of glioma patients with CONUT≥2.5 and<2.5 were 26.1%and 92.1%,NLR≥2.585 and<2.585 were 34.8%and 83.1%,and WHO grade II,III,and IV were 90.2%,55.2%,and 16.3%.Conclusions The prognosis of patients with glioma is poor.CONUT score,NLR,and WHO grading may be important predictive factors for prognosis of the patients.
作者
刘洋
连治琼
刘娟
曾晓玲
谢芳
LIU Yang;LIAN Zhi-qiong;LIU Juan;ZENG Xiao-ling;XIE Fang(Department of Neurosurgery,Yibin First Peoples’Hospital,Yibin 644000,China;Department of Neurosurgery,Yibin Second People’s Hospital,Yibin 644000,China;Department of Nursing,Yibin Third People’s Hospital,Yibin 644000,China)
出处
《实用医院临床杂志》
2025年第1期130-134,共5页
Practical Journal of Clinical Medicine
基金
四川省卫健委普及科研项目(编号:18PJ541)。
