The correlation between nutrition related blood biochemical indexes levels and PG-SGA score in preoperative patients with gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LING Chunrun , YE Zhou , BAI Lifen , WANG Mojin ,  ZHUANG Wen

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding?author：

ZHUANG Wen, Email: zw4794@163.com

Keywords：

gastric cancer; nutritional assessment; nutrition related blood biochemical indexes

DOI：

10.7507/1007-9424.201701003

Video：

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Objective To investigate the correlation between nutrition related blood biochemical indexes levels and Patient-Generated Subjective Global Assessment (PG-SGA) in preoperative nutritional assessment of patients with gastric cancer. Methods One hundred and seventeen gastric cancer patients who underwent surgery were enrolled in this study by the Department of Gastrointestinal Surgery of West China Hospital. Nutritional status of each patient was evaluated by PG-SGA, in the meantime, nutrition related blood biochemical indexes levels such as transferrin (TRF), prealbumin (PA), albumin (Alb), and hemoglobin (HGB) were measured by analysis of fasting venous blood, then take correlation analysis on the result. Results Eighty cases (68.4%) were in malnutrition (PG-SGA score≥4). The TRF, PA, Alb, and HGB in malnutrition patients were lower than those in non-malnutrition patients (PG-SGA score<4, n=37, P<0.05). The TRF, PA, Alb, and HGB levels of gastric cancer patients had significant negtive correlation with PG-SGA score, the correlation coefficients was –0.629, –0.545, –0.418, and –0.235, respectively (P<0.05). When the PG-SGA score was greater than or equal to 4 points, the optimum cutoff value for TRF, PA, Alb, and HGB was 2.31 g/L, 190.50 mg/L, 38.65 g/L, and 100.50 g/L, respectively (P<0.05). Conclusions The incidence of malnutrition is high in gastric cancer patients preoperatively. The TRF, PA, Alb, and HGB are significantly decreased in the patients with malnutrition, and these indicators has significant negtive correlation with PG-SGA score. The current study indicated that a gastric cancer patient might be in malnutrition when the biochemical levels are less than or equal to TRF 2.31 g/L, PA 190.50 mg/L, Alb 38.65 g/L, HGB 100.50 g/L, and sufficient attention should be paid when any of these occasions appear clinically. The combination of PG-SGA score and nutrition related blood biochemical indexes levels could provide a more accurate assessment of preoperative nutritional status, and the evidence of nutritional intervention for patients with gastric cancer.

Citation： LING Chunrun, YE Zhou, BAI Lifen, WANG Mojin, ZHUANG Wen. The correlation between nutrition related blood biochemical indexes levels and PG-SGA score in preoperative patients with gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(8): 958-962. doi: 10.7507/1007-9424.201701003 Copy

1.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2.	鄒文斌, 李兆申. 中國胃癌發病率及死亡率研究進展. 中國實用內科雜志, 2014, 34(4): 408-415.
3.	石漢平, 李蘇宜, 王昆華, 等. 胃癌患者營養治療指南. 腫瘤代謝與營養電子雜志, 2015, 2(2): 37-40.
4.	Choi WJ, Kim J. Nutritional care of gastric cancer patients with clinical outcomes and complications: a review. Clin Nutr Res, 2016, 5(2): 65-78.
5.	Fukuda Y, Yamamoto K, Hirao M, et al. Prevalence of malnutrition among gastric cancer patients undergoing gastrectomy and optimal preoperative nutritional support for preventing surgical site infections. Ann Surg Oncol, 2015, 22 Suppl 3: S778-S785.
6.	Lim HS, Cho GS, Park YH, et al. Comparison of quality of life and nutritional status in gastric cancer patients undergoing gastrectomies. Clin Nutr Res, 2015, 4(3): 153-159.
7.	Ottery FD. Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol, 1994, 21(6): 770-778.
8.	石漢平, 趙青川, 王昆華, 等. 營養不良的三級診斷. 中國癌癥防治雜志, 2015, 7(5): 313-319.
9.	陳旭艷, 曹建南, 蔡繼福, 等. 惡性腫瘤貧血患者血清轉鐵蛋白含量的測定及臨床意義. 臨床薈萃, 2004, 19(2): 106.
10.	李娟, 黃沈珺, 潘月龍, 等. 晚期腫瘤患者營養狀況檢測指標的研究. 重慶醫學, 2015, 44(35): 4953-4957.
11.	石漢平, 李薇, 王昆華. PG-SGA 腫瘤患者營養狀況評估操作手冊. 第 2 版. 北京: 人民衛生出版社. 2015: 30-35.
12.	Edge SB, Compton CC. The American Joint Commettee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 2010, 17(6): 1471-1474.
13.	Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr, 2002, 56(8): 779-785.
14.	CSCO腫瘤營養治療專家委員會. 惡性腫瘤患者的營養治療專家共識. 臨床腫瘤學雜志, 2012, 10(1): 59-73.
15.	吳蓓雯, 曹偉新, 費旭峰. 328 例消化道惡性腫瘤患者營養狀況評價. 上海交通大學學報(醫學版) , 2007, 27(5): 604-606.
16.	孫方園, 張蓓蕾, 張燕忠. 進展期胃癌患者前白蛋白水平與 PG-SGA 評分相關性分析. 腫瘤代謝與營養電子雜志, 2016, 3(3):170-173.
17.	Hébuterne X, Lemarié E, Michallet M, et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr, 2014, 38(2): 196-204.
18.	Seo SH, Kim SE, Kang YK, et al. Association of nutritional status-related indices and chemotherapy-induced adverse events in gastric cancer patients. BMC cancer, 2016, 16(1): 900.
19.	Zhou J, Hiki N, Mine S, et al. Role of prealbumin as a powerful and simple index for predicting postoperative complications after gastric cancer surgery. Ann surg oncol, 2017, 24(2): 510-517.
20.	Thoresen L, Fjeldstad I, Krogstad K, et al. Nutritional status of patients with advanced cancer: the value of using the subjective global assessment of nutritional status as a screening tool. Palliative Medicine, 2002, 16(1): 33-42.
21.	Devoto G, Gallo F, Marchello C, et al. Prealbumin serum concentrations as a useful tool in the assessment of malnutrition in hospitalized patients. Clin Chem, 2006, 52(12): 2281-2285.
22.	Bae HJ, Lee HJ, Han DS, et al. Prealbumin levels as a useful marker for predicting infectious complications after gastric surgery. J Gastrointest Surg, 2011, 15(12): 2136-2144.
23.	Grant JP, Custer PB, Thurlow J. Current techniques of nutritional assessment. Surg Clin North Am, 1981, 61(3): 437-463.
24.	Yovita H, Djumhana A, Abdurachman SA, et al. Correlation between anthropometrics measurements, prealbumin level and transferin serum with Child-Pugh classification in evaluating nutritional status of liver cirrhosis patient. Acta Med Indones, 2004, 36(4): 197-201.
25.	孫曉紅, 胡芳. 患者自評-主觀全面評定量表在胃腸惡性腫瘤患者營養篩查中的應用調查. 中國全科醫學, 2014, 17(14): 1643-1649.

1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. 鄒文斌, 李兆申. 中國胃癌發病率及死亡率研究進展. 中國實用內科雜志, 2014, 34(4): 408-415.
3. 石漢平, 李蘇宜, 王昆華, 等. 胃癌患者營養治療指南. 腫瘤代謝與營養電子雜志, 2015, 2(2): 37-40.
4. Choi WJ, Kim J. Nutritional care of gastric cancer patients with clinical outcomes and complications: a review. Clin Nutr Res, 2016, 5(2): 65-78.
5. Fukuda Y, Yamamoto K, Hirao M, et al. Prevalence of malnutrition among gastric cancer patients undergoing gastrectomy and optimal preoperative nutritional support for preventing surgical site infections. Ann Surg Oncol, 2015, 22 Suppl 3: S778-S785.
6. Lim HS, Cho GS, Park YH, et al. Comparison of quality of life and nutritional status in gastric cancer patients undergoing gastrectomies. Clin Nutr Res, 2015, 4(3): 153-159.
7. Ottery FD. Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol, 1994, 21(6): 770-778.
8. 石漢平, 趙青川, 王昆華, 等. 營養不良的三級診斷. 中國癌癥防治雜志, 2015, 7(5): 313-319.
9. 陳旭艷, 曹建南, 蔡繼福, 等. 惡性腫瘤貧血患者血清轉鐵蛋白含量的測定及臨床意義. 臨床薈萃, 2004, 19(2): 106.
10. 李娟, 黃沈珺, 潘月龍, 等. 晚期腫瘤患者營養狀況檢測指標的研究. 重慶醫學, 2015, 44(35): 4953-4957.
11. 石漢平, 李薇, 王昆華. PG-SGA 腫瘤患者營養狀況評估操作手冊. 第 2 版. 北京: 人民衛生出版社. 2015: 30-35.
12. Edge SB, Compton CC. The American Joint Commettee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 2010, 17(6): 1471-1474.
13. Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr, 2002, 56(8): 779-785.
14. CSCO腫瘤營養治療專家委員會. 惡性腫瘤患者的營養治療專家共識. 臨床腫瘤學雜志, 2012, 10(1): 59-73.
15. 吳蓓雯, 曹偉新, 費旭峰. 328 例消化道惡性腫瘤患者營養狀況評價. 上海交通大學學報(醫學版) , 2007, 27(5): 604-606.
16. 孫方園, 張蓓蕾, 張燕忠. 進展期胃癌患者前白蛋白水平與 PG-SGA 評分相關性分析. 腫瘤代謝與營養電子雜志, 2016, 3(3):170-173.
17. Hébuterne X, Lemarié E, Michallet M, et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr, 2014, 38(2): 196-204.
18. Seo SH, Kim SE, Kang YK, et al. Association of nutritional status-related indices and chemotherapy-induced adverse events in gastric cancer patients. BMC cancer, 2016, 16(1): 900.
19. Zhou J, Hiki N, Mine S, et al. Role of prealbumin as a powerful and simple index for predicting postoperative complications after gastric cancer surgery. Ann surg oncol, 2017, 24(2): 510-517.
20. Thoresen L, Fjeldstad I, Krogstad K, et al. Nutritional status of patients with advanced cancer: the value of using the subjective global assessment of nutritional status as a screening tool. Palliative Medicine, 2002, 16(1): 33-42.
21. Devoto G, Gallo F, Marchello C, et al. Prealbumin serum concentrations as a useful tool in the assessment of malnutrition in hospitalized patients. Clin Chem, 2006, 52(12): 2281-2285.
22. Bae HJ, Lee HJ, Han DS, et al. Prealbumin levels as a useful marker for predicting infectious complications after gastric surgery. J Gastrointest Surg, 2011, 15(12): 2136-2144.
23. Grant JP, Custer PB, Thurlow J. Current techniques of nutritional assessment. Surg Clin North Am, 1981, 61(3): 437-463.
24. Yovita H, Djumhana A, Abdurachman SA, et al. Correlation between anthropometrics measurements, prealbumin level and transferin serum with Child-Pugh classification in evaluating nutritional status of liver cirrhosis patient. Acta Med Indones, 2004, 36(4): 197-201.
25. 孫曉紅, 胡芳. 患者自評-主觀全面評定量表在胃腸惡性腫瘤患者營養篩查中的應用調查. 中國全科醫學, 2014, 17(14): 1643-1649.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The correlation between nutrition related blood biochemical indexes levels and PG-SGA score in preoperative patients with gastric cancer

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