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BMC Gastroenterology: 预后营养指数是≥85岁老年行胃内镜黏膜下剥离术治疗的独立预后因素

2021-09-26 MedSci原创 MedSci原创

内窥镜黏膜下剥离术 (ESD) 已被广泛接受为早期胃癌 (EGC) 的一线治疗方法,其淋巴结转移风险可忽略不计。

      内窥镜黏膜下剥离术 (ESD) 已被广泛接受为早期胃癌 (EGC) 的一线治疗方法,其淋巴结转移风险可忽略不计。最近,几项研究表明,即使在非治愈性 ESD 治疗老年 EGC 患者中,ESD 后 EGC 也具有极好的短期和长期结果。近几十年来,全球老年人口迅速增加。在日本,胃癌仍然是重要的死亡原因。然而,由于对老年患者进行 ESD 的必要性越来越高,医生面临着对患有多种合并症的老年患者进行胃 ESD 的适应症的问题。迄今为止,几项研究已经发现了 EGC治疗 ESD 患者生存的各种预后因素。然而,很少有研究确定 85 岁或以上接受 ESD 的 EGC 患者的预后因素。因此本研究的目的是探究 85 岁以上 EGC 老年患者 ESD 后生存的临床结果和预后因素。

 

      研究人员回顾性评估了 70 名年龄≥85 岁的 EGC 患者接受 ESD 治疗的临床结果。使用 Kaplan-Meier 方法和 Cox 比例风险模型分析总生存期 (OS) 的预后因素。

 

      研究显示:随访期间,33例患者死亡,但无一例死于胃癌。3 年后的 OS 概率为 90.0%。单变量分析显示,中性粒细胞/淋巴细胞比率≥ 2.6、预后营养指数 (PNI) < 42.5 和低血清白蛋白值 (< 3.5 g/dl) 与较差的 OS 相关。Cox 多变量分析显示低 PNI (< 42.5) 是与 OS 相关的独立预后因素(风险比;3.40,95% 置信区间;1.47-7.86,P= 0.004)。

 

       综上,PNI 可能是决定对 85 岁以上的 EGC 老年患者进行 ESD 的最有用的参数。

 

原始出处:

Yosuke Toya. Et al. Prognostic nutritional index is an independent prognostic factor for older patients aged ≥ 85 years treated by gastric endoscopic submucosal dissection. BMC Gastroenterology.2021.

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    2021-10-11 许安
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  5. 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  6. 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    2021-09-28 snowpeakxu
  9. 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