基于营养、免疫和炎症的联合指标预测脑胶质瘤患者的预后:一项多中心回顾性研究
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1重庆医药高等专科学校护理学院,重庆 401331 ; 2. 公共卫生与应急管理学院,重庆 401331 ; 3. 宜宾市第三人民医院护理部,四川 宜宾 644000 ; 4. 宜宾市第一人民医院神经外二科,四川 宜宾 644000 ; 5. 宜宾市第二人民医院神经外科,四川 宜宾 644000 ; 6. 重庆医药高等专科学校临床医学院,重庆 401331

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R739.4

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重庆市教育委员会科学技术研究计划(KJQN202202825);重庆市高等职业技术教育研究会科研项目(GY201057)


Joint indicators based on nutrition-immunity-inflammation for predicting the prognosis of patients with glioma: a multicenter retrospective study
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1School of Nursing ; 2. School of Public Health and Emergency Management, Chongqing Medical and Pharmaceutical College, Chongqing 401331 ; 3. Department of Nursing, the Third Peoples’ Hospital of Yibin, Yibin 644000 ; 4. Department of No. 2 Neurosurgery, the First Peoples’ Hospital of Yibin, Yibin 644000 ; 5. Department of Neurosurgery, the Second Peoples’ Hospital of Yibin, Yibin 644000 ; 6. School of Clinical Medicine, Chongqing Medical and Pharmaceutical College, Chongqing 401331 , China

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    摘要:

    目的:探讨基于营养、免疫和炎症的联合指标[控制营养状态(controlling nutritional status,CONUT)评分、那不勒斯预后评分(Naples prognostic score,NPS)、改良格拉斯哥预后评分(modified Glasgow prognostic score,mGPS)、全面免疫营养炎症指数(global immune-nutrition-inflammation index,GINI)、系统炎症反应指数(systemic inflammatory response index,SIRI)及C反应蛋白-白蛋白-淋巴细胞(C-reactive protein-albumin-lymphocyte,CALLY)指数]对脑胶质瘤患者预后的临床价值。方法:回顾性分析2015—2020年宜宾市3所综合性医院收治的151例脑胶质瘤患者的病历资料,门诊和电话随访患者临床结局至2024年12月30日,绘制受试者工作特征(receiver operating characteristic,ROC)曲线并计算各指标的曲线下面积(area under curve,AUC)和最佳截断值,Kaplan-Meier法绘制生存曲线,Log-rank检验和Cox回归分析可能影响患者生存结局的因素。结果:中位生存时间13(9,19)个月,随访期内死亡率70.2%(106/151),患者6个月和1年生存率(95%CI)分别为88.1%(83.6%~93.8%)和53.6%(45.6%~61.7%)。CONUT、GINI、SIRI和CALLY指数预测患者临床结局的最佳截断值分别为2.5、1 350、1.16和0.667,对应的AUC分别为0.960、0.948、0.883和0.979。世界卫生组织(World Health Organization,WHO)分级、手术方式、术前卡氏功能评分(Karnofsky performance status score,KPS)、体重指数(body mass index,BMI)、CONUT、NPS、mGPS、GINI、SIRI和CALLY等10个因素是患者预后的可能影响因素(P<0.05)。CONUT、NPS、CALLY指数、WHO分级与脑胶质瘤患者预后有关,其风险比(hazard ratio,HR)分别为0.228、0.401、3.012、3.653(Ⅲ级)和5.623(Ⅳ级)。CONUT≥3和<3的脑胶质瘤患者1年生存率分别为26.1%和92.1%,NPS≤2和>2的患者1年生存率分别为89.5%和31.9%,CALLY指数≥0.667和<0.667的脑胶质瘤患者1年生存率分别为89.5%和31.9%,WHO分级Ⅱ级、Ⅲ级和Ⅳ级患者1年生存率分别为90.2%、55.2%和16.3%。结论:脑胶质瘤预后不良,CONUT、NPS、CALLY指数和WHO分级可能是患者预后的重要预测因子。

    Abstract:

    Objective: To explore the clinical value of joint indicators based on nutrition-immunity-inflammation [controlling nutritional status(CONUT) score, Naples prognostic score(NPS), modified Glasgow prognostic score(mGPS), global immune-nutrition-inflammation index (GINI), systemic inflammatory response index (SIRI), and C-reactive protein-albumin-lymphocyte (CALLY) index] for the prognosis of glioma patients. Methods: A retrospective analysis was conducted on the medical records of 151 patients with glioma admitted to three comprehensive hospitals in Yibin from 2015 to 2020. The clinical outcomes of outpatient were followed up until December 30, 2024 by telephone or outpatient service. Receiver operating characteristic (ROC) curves were plotted for calculating the area under the curve(AUC) and optimal cutoff values of each indicator. Kaplan-Meier method was used to plot survival curves, Log-rank test and Cox regression analysis were used to identify influencing factors of survival outcomes. Results: The median survival time was 13(9,19) months, and the mortality rate during follow-up was 70.2%(106/151). The 6-month and 1-year survival rates (95% CI) of patients were 88.1%(83.6%–93.8% ) and 53.6%(45.6%–61.7% ), respectively. The optimal cut-off values of CONUT, GINI, SIRI, and CALLY index for predicting patients’ prognosis were 2.5, 1 350, 1.16, and 0.667, respectively, with corresponding AUC values of 0.960, 0.948, 0.883, and 0.979, respectively. Ten factors, including WHO grading, surgical approach, preoperative KPS score, body mass index (BMI), CONUT, NPS, mGPS, GINI, SIRI, and CALLY index, were influencing factors for patients’ prognosis(P < 0.05). CONUT, NPS, CALLY index, and WHO grading were associated with the prognosis of glioma patients, with hazard ratio(HR) values of 0.228, 0.401, 3.012, 3.653(grade Ⅲ), and 5.623(grade Ⅳ), respectively. The one-year survival rates of glioma patients with CONUT ≥ 3 and <3 were 26.1% and 92.1%, respectively. The one-year survival rates of patients with NPS ≤2 and >2 were 89.5% and 31.9%, respectively. The one-year survival rates of glioma patients with CALLY index≥0.667 and <0.667 were 89.5% and 31.9%, respectively. The one-year survival rates of WHO grade Ⅱ, Ⅲ, and Ⅳ patients were 90.2%, 55.2%, and 16.3%, respectively. Conclusion: Patients with glioma have poor prognosis, and CONUT, NPS, CALLY index, and WHO grading may be important predictors of patient prognosis.

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董志甫,刘峰,谢芳,刘洋,曾晓玲,程元辉.基于营养、免疫和炎症的联合指标预测脑胶质瘤患者的预后:一项多中心回顾性研究[J].南京医科大学学报(自然科学版),2026,46(10):1511-1517

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  • 收稿日期:2025-12-25
  • 最后修改日期:2026-06-15
  • 录用日期:2026-07-12
  • 在线发布日期: 2026-10-19
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