| Objective:Using different methods to know the nutritional status of the hospitalized patients with gynecological malignant tumor before initial treatment(48 h or less hospitalized time),through the nutritional status of patients with gynecological malignant tumor,clear the patient's nutritional status and degree of malnutrition.Analyzing if the nutritional status is related to the clinical pathological characteristics such as the patient'age,tumor'type,stage of tumor,if they were treated or not and distant organ metastasis.Methods:The evaluation was finished within 48 hours(?48h)after the admission of gynecological malignant tumor patients by professionals,including age,height,weight,diagnosis,previous tumor-related treatment,blood routine and blood biochemical indicators,etc.The Body mass index(BMI)and Prognostic nutrition index(PNI)were calculated.Using NRS 2002 and PG-SGA to assess the hospitalized patients'nutritional status with gynecologic malignant tumor.Analyzing if NRS 2002,PG-SGA and PNI are related to the clinical pathological characteristics such as the patient'age,BMI,tumor's type,the stage of tumor,if they were treated or not and distant organ metastasis.Using the NRS 2002 as the diagnostic standard for nutritional risk(gold standard)to analyzed the sensitivity,specificity of PG-SGA and PNI?Results:There were a total of 125 patients enrolled,ranging in age from 30 to 74(mean age 55.1±5.3)years old,including 20(16.0%)patients aged?65 years old,and 105(84.0%)patients<65 years old.There were 34 cases of ovarian cancer(27.2%),70 cases of cervical cancer(56.0%),17 cases of endometrial cancer(13.6%),3 cases of fallopian tube cancer(2.4%),and 1 case of vulvar cancer(0.8%).A total of 78 cases(62.4%)in stage I and II and 47 cases(37.6%)in stage III and IV were studied.Fifty-eight(46.4%)patients had received prior treatment and 67(53.6%)patients had not received prior treatment.There were 51 cases(40.8%)with tumor metastasis and 74 cases(59.2%)without metastasis.There were 5 cases(4.0%)with BMI<18.5 and 120 cases(96.0%)with BMI?18.5.NRS 2002?3 points in 35 cases(28.0%)and NRS 2002<3 points in 90cases(72%).NRS 2002 was not related to age(?~2=0.047,P>0.05),NRS 2002 and BMI(?~2=9.774,P<0.05),tumor type(?~2=12.953,P<0.05),and tumor stage(?~2=19.874,P<0.05),previous treatment(?~2=7.291,P<0.05),and tumor metastasis(?~2=15.522,P<0.05)were correlated,and the differences were statistically significant.There were 69cases(55.2%)with PG-SGA?4 points,and 56 cases(44.8%)with PG-SGA<4points.PG-SGA was not related to age(?~2=0.222,P>0.05),PG-SGA was associated with BMI(?~2=9.774,P<0.05),tumor type(?~2=17.715,P<0.05),tumor stage(?~2=27.241,P<0.05),previous treatment(?~2=51.946,P<0.05),and tumor metastasis(?~2=38.018,P<0.05),and the differences were statistically significant.According to the NRS 2002 as the state variable(gold standard),the PG-SGA and PNI as the test variables to draw the ROC curve,the sensitivity of PG-SGA was 0.857,the specificity was 0.600,and the Youden index was 0.457.The area under the ROC curve of PNI was 0.599(95%confidence interval:0.483~0.716),and the critical value of PNI was 46.05 with the maximum of0.208.The sensitivity and specificity were 0.486 and 0.722 respectively.There were 57cases(45.6%)with PNI<46.05,and 68 cases(54.4%)with PNI?46.05.PNI was independent of age(?~2=3.612,P>0.05),BMI(?~2=0.435,P>0.05),and tumor type(?~2=3.073,P>0.05).PNI was correlated with tumor stage(?~2=10.091,P<0.05),previous treatment(?~2=13.304,P<0.05),and tumor metastasis(?~2=12.677,P<0.05),and the differences were statistically significant.The consistency of PG-SGA and PNI was tested by Kappa according to NRS 2002.The PG-SGA score was consistent with the NRS 2002 score(Kappa=0.419,P<0.001).The consistency between PNI value of46.05 and NRS 2002 was poor(Kappa=0.134,P>0.05)?Conclusion:Hospitalized patients with gynecologic malignancies are at higher risk of malnutrition,and ovarian cancer is more significant.The risk of malnutrition was associated with BMI,tumor type,tumor stage,previous treatment,and tumor metastasis,regardless of the patient's age.The sensitivity and specificity of PG-SGA are good,and the consistency between PG-SGA and NRS2002 is good.The best cut-off point of PNI was 46.05,and the consistency between PNI and NRS2002 was poor?... |
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