Citation: | TANG Ling, WANG Wei, HAO Qiyan, WANG Jingjing. Influencing factors and construction of risk prediction model of malnutrition in patients with gastric cancer undergoing chemotherapy[J]. Journal of Clinical Medicine in Practice, 2024, 28(7): 79-84. DOI: 10.7619/jcmp.20231795 |
To analyze the risk factors of malnutrition in patients with gastric cancer undergoing chemotherapy and construct a nomogram prediction model.
A total of 152 patients who received complete chemotherapy were selected as study subjects. After complete chemotherapy, the patients were divided into well-nourished group (n=46) and undernourished group (n=106) according to the nutritional evaluation results. Logistic regression analysis was used to screen the influencing factors of malnutrition in patients with gastric cancer undergoing chemotherapy. A nomogram model was constructed to predict the risk of malnutrition in patients with gastric cancer undergoing chemotherapy. Receiver operating characteristic (ROC) curve and calibration curve were used to verify the differentiation and consistency of the nomogram model.
Among 152 patients with gastric cancer treated with chemotherapy, 106 were malnourished, the incidence rate was 69.74%. Male (95%CI, 1.232 to 6.292, P=0.014), no parenteral nutrition support during chemotherapy (95%CI, 1.528 to 7.781, P=0.003), hypoproteinemia (95%CI, 1.193 to 76.786, P=0.033), early satiety (95%CI, 1.259 to 82.652, P=0.030) were independent risk factors for malnutrition in patients with gastric cancer undergoing chemotherapy. The area under ROC curve was 0.757 (95%CI, 0.680 to 0.833). The slope of calibration curve was close to 1, and the Hosmer-Lemeshow goodness of fit test was good (χ2=5.834, P=0.442).
Male, lack of parenteral nutrition support during chemotherapy, hypoproteinemia and early satiety are independent risk factors for malnutrition inpatients with gastric cancer undergoing chemotherapy. The prediction nomogram model built on this basis has good differentiation and consistency.
[1] |
杨之洵. 中国胃癌负担趋势及预测研究[D]. 北京: 北京协和医学院, 2019.
|
[2] |
谢通, 沈琳. 2021年度胃癌治疗进展[J]. 肿瘤综合治疗电子杂志, 2022, 8(1): 56-60. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLZD202301001.htm
|
[3] |
潘丽, 尉浩斌, 刘伟巍, 等. 消化道肿瘤营养不良患者外周血炎症指标水平临床研究[J]. 肿瘤代谢与营养电子杂志, 2021, 8(5): 539-544. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLDX202105014.htm
|
[4] |
沈磊, 杨海涛, 杨春建. 合肥市属部分医疗机构消化道恶性肿瘤住院患者营养现状调查分析[J]. 现代肿瘤医学, 2020, 28(6): 980-983. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZL202006025.htm
|
[5] |
李树霞, 李庆红, 李秀芬, 等. 消化道恶性肿瘤营养不良患者的临床评估方法[J]. 承德医学院学报, 2012, 29(1): 68-69. https://www.cnki.com.cn/Article/CJFDTOTAL-CDYX201201042.htm
|
[6] |
郭信伟, 王秀娟, 周绍兵, 等. 整合术前营养指标的列线图对中老年胸段食管鳞状细胞癌患者预后的影响[J]. 中国老年学杂志, 2023, 43(3): 529-533. doi: 10.3969/j.issn.1005-9202.2023.03.006
|
[7] |
郝红梅, 黄海玲, 张微, 等. 慢性心力衰竭患者营养不良风险列线图预测模型的构建与验证[J]. 现代预防医学, 2022, 49(17): 3130-3135. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202217011.htm
|
[8] |
孙晓红, 胡芳. 患者自评-主观全面评定量表在胃肠恶性肿瘤患者营养筛查中的应用调查[J]. 中国全科医学, 2014, 17(14): 1643-1645, 1649. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX201414022.htm
|
[9] |
OTTERY F D. Definition of standardized nutritional assessment and interventional pathways in oncology[J]. Nutrition, 1996, 12(1 Suppl): S15-S19.
|
[10] |
DAS U, PATEL S, DAVE K, et al. Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters[J]. South Asian J Cancer, 2014, 3(1): 38-42. doi: 10.4103/2278-330X.126518
|
[11] |
赵建兰, 王瑞景, 程慧. 基于自评-主观全面量表的个体化营养干预对妇科肿瘤术后化疗患者营养状态及免疫功能的影响[J]. 癌症进展, 2023, 21(2): 169-172. https://www.cnki.com.cn/Article/CJFDTOTAL-AZJZ202302010.htm
|
[12] |
刘一凝, 崔久嵬. 肿瘤患者围化疗期的营养管理进展[J]. 肿瘤代谢与营养电子杂志, 2022, 9(5): 672-680. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLDX202205018.htm
|
[13] |
宗立翎, 杨晶, 薛胜利, 等. 急性白血病患者化疗期间营养状况变化的观察研究[J]. 中国实验血液学杂志, 2022, 30(4): 1028-1033. https://www.cnki.com.cn/Article/CJFDTOTAL-XYSY202204009.htm
|
[14] |
夏爱丹, 朱凯铨, 朱淼勇. 老年肺癌患者化疗期间发生中重度营养不良的影响因素[J]. 中国老年学杂志, 2022, 42(12): 2896-2899. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ202212013.htm
|
[15] |
毛玲红, 陈姬雅, 高娅芬. 肺癌患者化疗期间营养不良风险及影响因素研究[J]. 中华现代护理杂志, 2019, 25(15): 1933-1937.
|
[16] |
张瑜, 张文青, 吴义霞. 胃癌术后化疗患者营养风险评估及影响因素研究[J]. 解放军预防医学杂志, 2020, 38(8): 70-72, 76. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYX202008023.htm
|
[17] |
屈清荣, 徐一格, 何卫芳, 等. 胃癌根治术患者化疗末期营养状况及影响因素分析[J]. 中国实用护理杂志, 2017, 33(20): 1530-1535.
|
[18] |
毕研霞, 洪忠新, 张立红, 等. 肿瘤化疗患者营养风险评估及影响因素分析[J]. 中国食物与营养, 2018, 24(3): 66-70. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWY201803015.htm
|
[19] |
孙雷雷, 李洁茹, 马怀幸, 等. 肿瘤病人营养状况调查及其影响因素分析[J]. 蚌埠医学院学报, 2019, 44(12): 1637-1642. https://www.cnki.com.cn/Article/CJFDTOTAL-BANG201912018.htm
|