| 韦 斌,钟晓刚,麦 威,黄顺荣,牙韩清,王晓通.内脏脂肪面积及体质量指数对结直肠癌根治术患者疗效的影响及其预测价值分析[J].,2021,(11):2153-2158 |
| 内脏脂肪面积及体质量指数对结直肠癌根治术患者疗效的影响及其预测价值分析 |
| The Effect of Visceral Fat Area and Body Mass Index on Curative Effect of Colorectal Cancer Patients Undergoing Radical Resection and Its Predictive Value Analysis |
| 投稿时间：2021-01-08 修订日期：2021-01-31 |
| DOI：10.13241/j.cnki.pmb.2021.11.034 |
| 中文关键词: 结直肠癌根治术 内脏脂肪面积 体质量指数 并发症 预后 预测 |
| 英文关键词: Radical resection of colorectal cancer Visceral fat area Body mass index Complication Prognosis Predicting |
| 基金项目:广西壮族自治区卫生和计划生育委员会自筹经费科研课题（Z2015363，Z2016580） |
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| 中文摘要: |
| 摘要 目的：探讨内脏脂肪面积及体质量指数（BMI）对结直肠癌根治术患者疗效的影响，并分析其对术后并发症、预后的预测价值。方法：前瞻性选取我院2017年5月～2019年12月收治的结直肠癌根治术患者126例，所有患者术前均进行体格检查，记录内脏脂肪面积（VFA）与BMI。根据VFA将其分成高脂肪组（VFA≥100cm2，n=43）、低脂肪组（VFA＜100cm2，n=83），根据BMI分成未超重组（BMI＜24kg/m2，n=78）、超重组（BMI≥24kg/m2，n=48），比较不同VFA、BMI患者的围手术期疗效指标及并发症发生率。术后随访1年，比较不同VFA、BMI患者的预后情况，绘制受试者工作特征（ROC）曲线分析VFA、BMI预测并发症、预后的曲线下面积（AUC）。结果：高脂肪组手术时间、术后排气时间较低脂肪组延长，术中出血量高于低脂肪组，淋巴结清扫数目低于低脂肪组（P＜0.05）。超重组手术时间、术后排气时间较未超重组延长，术中出血量高于未超重组（P＜0.05）。高脂肪组总并发症发生率和预后不良率高于低脂肪组（P＜0.05）。 超重组的总并发症发生率为18.75%，高于未超重组的6.41%（P＜0.05），但是两组预后比较无差异（P>0.05）。ROC曲线提示，VFA、BMI预测术后并发症的AUC分别为0.784（P=0.001，95%CI：0.683-0.885）、0.740（P=0.004，95%CI：0.608-0.872）。VFA、BMI预测预后的AUC分别为0.776（P=0.002，95%CI：0.667-0.885）、0.667（P=0.058，95%CI：0.517-0.817）。结论：VFA、BMI过高均会影响结直肠癌根治术患者的疗效，并增加并发症发生率，其中VFA过高还会增加预后不良风险，VFA预测术后并发症及预后的效果优于BMI。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effects of visceral fat area and body mass index (BMI) on the curative effect of colorectal cancer patients undergoing radical resection, and to analyze their predictive value for postoperative complications and prognosis. Methods: A prospective selection of 126 cases of colorectal cancer patients undergoing radical resection in our hospital from May 2017 to December 2019 were selected. All patients underwent physical examination before surgery, the visceral fat area (VFA) and BMI were recorded. According to VFA, they were divided into high-fat group (VFA≥100cm2, n=43), low-fat group (VFA＜100 cm2, n=83), and according to BMI, they were divided into non-overweight group (BMI＜24kg/m2, n=78) and overweight group (BMI≥24kg/m2, n=48). The perioperative efficacy indexes and complication rate of patients with different VFA and BMI were compared. After 1 year follow-up, the prognosis of patients with different VFA and BMI were compared, and the receiver operating characteristic (ROC) curve was drawn to analyze the area under the curve (AUC) for predicting complications and prognosis of VFA and BMI. Results: The operation time and the postoperative exhaust time of the high-fat group were prolonged those in the low-fat group, the intraoperative blood loss was higher than that of the low-fat group, and the number of lymph node dissections was lower than that of the low-fat group (P<0.05). The operation time and postoperative exhaust time in the overweight group were prolonged than those in the non-overweight group and the intraoperative blood loss was higher than that in the non-overweight group (P<0.05). The incidence rate of total complications and poor prognosis in high-fat group were higher than those in low-fat group (P＜0.05). The total complication rate of overweight group was 18.75%, which was higher than 6.41% non-overweight group (P＜0.05), but there was no difference in prognosis between the two groups (P>0.05). The ROC curve indicated that the AUC of VFA and BMI predicting postoperative complications were 0.784 (P=0.001, 95%CI: 0.683-0.885) and 0.740 (P=0.004, 95%CI: 0.608-0.872), respectively. The prognostic AUC of VFA and BMI were 0.776 (P=0.002, 95%CI: 0.667-0.885) and 0.667 (P=0.058, 95%CI: 0.517-0.817), respectively. Conclusion: Excessive VFA and BMI will affect the curative effect of colorectal cancer patients undergoing radical resection, and increase the incidence rate of complications. Excessive VFA will also increase the risk of poor prognosis. VFA is better than BMI in predicting postoperative complications and prognosis. |
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