| Objective:To evaluate the clinical value of OPNI in the evaluation of nutritional risk in patients with gastric cancer during perioperative period.Methods:A retrospective analysis of 264 cases of gastric cancer patients undergoing elective surgery in Northern Jiangsu People’s Hospital(NJPH)from July 2014 to June 2015 were performed on preoperative European Nutrition Risk Screening 2002(NRS2002)and OPNI score.The preoperative Nutrition Risk Screening 2002(NRS2002)score and OPNI score were calculated.NRS2002 screening results for the diagnosis of nutritional risk of gold standard(score ≥ 3 points in patients with nutritional risk group,score<3 points in patients with non-nutritional risk group).OPNI = Alb(109/L)+ 5 X TLC(109/L)was calculated from serum albumin(Alb)and total number of peripheral blood lymphocytes(TLC),according to the results of blood routine and blood biochemical tests three days before surgery.To analyze the relationship between NRS2002,OPNI and clinicopathological features such as age,tumor location,pathological type and TNM staging.The outcome of the nutrition risk group and the group without nutrition risk group was used as the state variable and the OPNI score as the test variable to draw the receiver operating characteristic curve(ROC).The sensitivity,specificity,Jordan index,and area under the curve were analyzed to determine the optimal cutoff point for OPNI for nutrition risk assessment,and the cases were divided into two groups according to the cut-off point.Kappa test was used to compare the consistency of different OPNI cutoff points with NRS2002 nutritional risk screening.The relationship between OPNI and postoperative complications was also analyzed.Results:There were 118 patients(44.7%)with NRS2002 score<3(no nutrition risk group)while 146 patients(55.3%)with NRS2002 score ≥3(with nutrition risk group).NRS2002 was not associated with tumor location and pathological type,P>0.05.NRS2002 score was related to patient age,χ2 values 12.459,P<0.001,Spearman correlation R value 0.217.NRS2002 score is related to T staging,χ2 values 45.534,P<0.001,Spearman correlation R value 0.051,and N staging,χ2 value 17.618,P<0.001,Speannan correlation R value 0.059.The OPNI score was(47.40 ± 7.01).The ROC curve shows that the area under the ROC curve is 0.870(95%CI:0.872～0.919)and the critical value of OPNI is 45.6 when the maximum number is about 0.750.The sensitivity of the cut-off point is 87.7%,the specificity was 87.2%.The patients were divided into OPNI ≥45.6 group(143 cases)and OPNI<45.6 group(121 cases)with the optimal cut-off point as the threshold.There was no correlation between OPNI and tumor location and pathological type,P>0.05.OPNI was associated with patient age,χ2 value 10.201,P<0.001,Spearman correlation R value 0.061;patients with T stage,χ2 value 24.719,P<0.001,Spearman correlation R value 0.056;OPNI and patients with N staging,χ2 value 14.053,P = 0.003,Spearman correlation R value 0.059.The kappa test showed that OPNI had a good consistency with NRS2002 for nutritional risk screening(Kappa = 0.748,p<0.001)when OPN was 45.6 as the critical value.To analyze the incidence of complications,we found that OPNI ≥45.6(no nutritional risk group)143 cases,all radical gastrectomy surgery,a total of 14 cases of complications,including anastomotic fistula in 1 case,incision infection in 4 cases,incision 1 case of anastomotic bleeding,2 cases of postoperative intestinal obstruction,3 cases of pulmonary infection.OPNI<45.6(nutritional risk group)121 cases,120 cases of radical gastrectomy surgery,1 case of distant metastasis of gastric cancer combined with radical left lobe of radical resection.A total of 35 cases of postoperative complications,including anastomotic fistula in 3 cases,incision infection in 10 cases,incision in 3 cases,anastomotic bleeding in 5 cases,postoperative intestinal obstruction in 7 cases,7 cases of pulmonary infection.The difference between the two groups was statistically significant(P = 0.014).Conclusion:OPNI can better reflect the nutritional status of gastric cancer patients and predict the risk of surgery.It has a good diagnostic and evaluation value for the perioperative nutritional risk of gastric cancer patients.OPNI = 45.6 can be used as a diagnostic threshold for nutritional risk. |
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