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2025 Vol. 12, No. 3
Published: 2025-06-09
 
283 The key points and difficulties in the whole nutritional management of surgical patients
The incidence rates of nutritional risk and malnutrition among surgical patients are relatively high which are key factors affecting the surgical prognosis and the rehabilitation process. A large number of studies have confirmed that for surgical patients with nutritional risk and malnutrition before surgery formulating a nutritional support treatment plan in a timely manner and implementing it in a standardized way are important measures to reduce postoperative complications. Whole-course nutritional management runs through all stages before surgery after surgery and after discharge. Its core elements include five links nutritional screening assessment diagnosis intervention and monitoring. By establishing a multidisciplinary nutritional support treatment team led by surgeons nutritional diagnosis and treatment are carried out in a standardized manner according to the metabolic characteristics of surgical patients at different stages of the perioperative period. Combining with the current status of surgical nutritional management in China this article focuses on discussing key issues in whole -course nutritional management such as prehabilitation before surgery early enteral nutrition after surgery and oral nutritional supplementation after discharge with a view to promoting the postoperative rehabilitation process. However in the implementation process of whole-course nutritional management there are still difficulties such as insufficient human resources lagging professional training lack of standardized processes and policy support which restrict its widespread promotion and standardized application. In the future with the increasing attention paid by medical institutions at all levels relying on the guidance of clinical nutrition experts and professional societies and strengthening discipline construction and multidisciplinary collaboration it is expected to promote the in-depth development of whole-course nutritional management provide more precise and efficient nutritional support treatment for the rapid rehabilitation of surgical patients continuously improve the quality of medical care and optimize the health economic benefits.
2025 Vol. 12 (3): 283-286 [Abstract] ( 31 ) HTML PDF (816 KB)  ( 36 )
287 Research progress on the application of whole-course nutrition management in perioperative patients
1 2Li Yonghao,3Li Zijian, 1Zhu Mingwei
The application of comprehensive nutrition management in perioperative patients is of great significance. The perioperative period covers three stages pre - operation post - operation and the 30 days after discharge. Through systematic dynamic and individualized precise nutrition intervention strategies comprehensive nutrition management comprehensively optimizes the nutritional status of patients. Research shows that the nutritional status directly affects the postoperative prognosis rehabilitation process and long-term quality of life of patients. In the pre-operative stage identifying patients with nutritional risks and malnutrition through standardized screening tools and implementing nutritional support for at least 7 days can significantly improve hypoproteinemia reduce the postoperative infection rate and increase the survival rate. For patients undergoing gastrointestinal surgery replacing traditional bowel preparation with enteral nutrition before surgery can reduce intestinal mucosal damage while maintaining nutritional status. In the postoperative stage the early initiation of enteral nutrition can accelerate the recovery of intestinal function shorten the length of hospital stay and reduce the risk of infection. For patients with limited intestinal function supplemental parenteral nutrition is required to ensure energy and protein intake while avoiding metabolic complications. Within 30 days after discharge patients still face the risk of malnutrition. In particular the continuous application of oral nutritional supplements needs to be emphasized. It can effectively reduce skeletal muscle loss improve the tolerance to chemotherapy and enhance compliance through remote monitoring and digital tools. However in current clinical practice there are still problems such as the inconsistent application of nutritional screening tools insufficient standardization of intervention measures and unclear timing of support for special patient groups. Based on the literature retrieval strategy this article systematically reviews the latest research progress of comprehensive nutrition management during the perioperative period including nutritional screening criteria intervention programs implementation paths and health economic benefits. It aims to provide clinicians with an individualized management framework for multidisciplinary collaboration optimize nutritional support strategies ultimately reduce the incidence of complications shorten the rehabilitation period and improve the quality of life of patients.
2025 Vol. 12 (3): 287-292 [Abstract] ( 36 ) HTML PDF (911 KB)  ( 34 )
293 Effects of nutritional interventions on the prevention and control of cognitive impairment in the elderly
Li Fangzhou,Wu Difei,Chen Xujiao
Alzheimer ' s disease AD is a major global neurodegenerative disease and the most common type of cognitive impairment. Currently modifiable risk factors for AD particularly nutritional interventions have attracted significant attention in the prevention and control of cognitive impairment. Numerous randomized controlled trials investigating the relationships between dietary patterns nutrient intake functional nutritional foods and cognitive impairment prevention or AD treatment indicate that the efficacy of nutrition in maintaining cognitive function in the elderly remains controversial posing challenges to establishing effective prevention measures. This review summarizes the associations between various dietary patterns key nutrient levels and supplementation functional food-derived bioactive compounds and cognitive decline. It explores the potential roles and mechanisms of dietary patterns and nutritional supplementation in AD prevention and treatment. Dietary patterns such as the Mediterranean diet MIND diet Mediterranean-DASH Intervention for Neurodegenerative Delay and ketogenic diet as well as nutrients including B vitamins vitamin D vitamin E Omega-3 fatty acids selenium and zinc and functional bioactive compounds such as anthocyanins and soy isoflavones may help reduce the risk of cognitive decline offering additional protective effects particularly for APOEε4 carriers. Future research should integrate genetic and metabolic factors enhance long-term follow-up studies and leverage multi-omics data to explore more precise and personalized nutritional intervention strategies. This approach aims to optimize cognitive management and provide scientific evidence for AD prevention and control.
2025 Vol. 12 (3): 293-300 [Abstract] ( 35 ) HTML PDF (910 KB)  ( 127 )
301 Expert consensus on nutritional interventions of digestive system nutrition impact symptoms in cancer patients
Zhejiang Nutrition Society Clinical Nutrition Professional Committee
Nutrition impact symptoms NIS encompass a series of clinical symptoms that can negatively affect the nutritional status of patients by impairing food intake and nutritional status. Cancer itself and / or related treatments can impact food digestion and absorption leading to NIS including nausea vomiting abdominal pain and diarrhea. The incidence of one or more NIS in cancer patients can be as high as 64% resulting in reduced food intake and deficiencies in energy protein and micronutrients. This in turn leads to weight loss and overall functional impairment ultimately triggering nutrition-related complications that negatively affect disease prognosis and clinical outcomes. This article focuses on nine common NIS associated with the digestive system in cancer patients and provides guidance and recommendations from a nutritional therapy perspective to support clinical treatment.
2025 Vol. 12 (3): 301-312 [Abstract] ( 37 ) HTML PDF (1629 KB)  ( 54 )
313 Nutrient composite index was constructed by principal component model to predict the prognosis of patients with gastric cancer
1Liu Yani,2Wang Lihong,3Chang Gongmin,3Xia Xiuling,2Sun Lulu,3Wang Kaijin
Objective To explore the predictive efficacy of nutrient composite index based on principal component model for prognosis of patients with gastric cancer. Method A total of 210 patients with gastric cancer who were treated by Beijing Nuclear Industry Hospital from January 2019 to December 2020 and were followed up until December 2023 were selected as the study objects. The patients were divided into poor prognosis group n = 57 and good prognosis group n = 153 according to whether there was recurrence or distant metastasis or death within 3 years of postoperative follow-up. Baseline data gender age BMI smoking history drinking history hypertension history diabetes history tumor size clinical stage differentiation degree preoperative lymph node metastasis vascular invasion trace elements copper Cu zinc Zn iron Fe magnesium Mg selenium Se Cu / Zn ratio were compared between the two groups. Spearman method was used to analyze the correlation between trace elements and clinical characteristics of gastric cancer patients. Pearson method was used to analyze the correlation between the indexes of trace elements. The parameters of nutrient composite index were constructed by principal component analysis and the AUC sensitivity and specificity of nutrient composite index in predicting prognosis of patients with gastric cancer were analyzed by drawing receiver operating characteristic ROC curve. Result The proportion of clinical stage Ⅲ low differentiation preoperative lymph node metastasis,vascular invasion and other baseline data Cu and Cu / Zn in the poor prognosis group were higher than those in the good prognosis group while Zn Mg and Se were lower than those in the good prognosis group P < 0. 05 . There was no significant difference in Fe between the two groups P > 0. 05 . Spearman correlation analysis showed that clinical stage differentiation degree preoperative lymph node metastasis and vascular invasion were positively correlated with Cu and Cu / Zn and negatively correlated with Zn Mg and Se P < 0. 05 . The results of principal component analysis showed that the weight coefficients of Zn Mg Se Cu / Zn and Cu were all > 0. 1 suggesting that they had a great impact on the prognosis of patients with gastric cancer. ROC curve analysis results showed that the AUC values of Cu Zn Mg Se Cu / Zn and composite index in predicting the prognosis of gastric cancer patients were 0. 637 0. 680 0. 739 0. 752 0. 769 0. 819. Conclusion In patients with poor prognosis of gastric cancer the abnormal expression of Cu Zn Mg Se Cu / Zn and other nutrients indicates that their expression levels are affected by prognosis. Dynamic monitoring of micronutrient changes is conducive to providing a reference for evaluating the prognosis of patients with gastric cancer
2025 Vol. 12 (3): 313-319 [Abstract] ( 29 ) HTML PDF (1323 KB)  ( 5 )
320 Prognostic value of nutritional index combined with inflammatory factors in predicting prognosis of patients with bone metastases
Huang Rongrong, Lai Baozhen, Chen Chunting, Yang Juan
Objective To investigate the expression of prognostic nutrition index PNI combined with neutrophil / lymphocyte ratio NLR and C-reactive protein / albumin ratio CAR in patients with bone metastases and its effect on prognosis. Method A total of 200 patients with bone metastases diagnosed and treated in our hospital from January 2020 to June 2023 and followed up to December 2023 were selected as the study subjects and set as the bone metastases group while 102 healthy subjects were selected as the control group during the same period. The changes of PNI NLR and CAR in the two groups were compared. The changes of PNI NLR and CAR in different pathological features of bone metastases were observed. Spearman method was used to analyze the correlation between PNI NLR CAR and clinical features of patients with bone metastases. Multivariate Cox regression risk model was used to analyze the effects of PNI NLR and CAR on the overall survival time of patients with bone metastases. ROC curve model was drawn to analyze the predictive efficacy of PNI NLR CAR and the three combinations in predicting the prognosis of patients with bone metastases. Result PNI in bone metastatic tumor group was lower than that in control group NLR and CAR were higher than that in control group P< 0. 05 . There were statistically significant differences among different bone metastasis types combined with other site metastasis bone changes ECOG score PNI NLR and CAR of SREs P<0. 05 . Correlation analysis showed that PNI was negatively correlated with bone metastasis type combined with other site metastasis ECOG score and SREs P<0. 05 . NRI and CAR were positively correlated with bone metastasis type other site metastasis bone changes ECOG score and SREs P<0. 05 . Cox regression risk model analysis showed that decreased PNI and increased NLR and CAR were independent influencing factors for overall survival of patients with bone metastases P<0. 05 . ROC curve analysis showed that the AUC values of PNI NLR CAR and the combination in predicting the prognosis of patients with bone metastases were 0. 915 0. 766 0. 759 0. 951. Conclusion The decrease of PNI and the increase of NLR and CAR are significantly correlated with the prognosis of patients with bone metastases. Monitoring the changes of PNI NLR and CAR levels is conducive to providing references for clinical treatment.
2025 Vol. 12 (3): 320-326 [Abstract] ( 33 ) HTML PDF (1278 KB)  ( 10 )
327 Development trajectory of geriatric nutritional risk index and its correlation with quality of life in lymphoma elderly patients during chemotherapy
Zhou Wen, Pu Yiqin, Xing Shuangshuang, Li Yue
Objective Exploring the trajectories of nutritional risk index changes during chemotherapy in lymphoma patients analyzing the influencing factors of different trajectories and exploring their correlation with quality of life. Method A longitudinal survey of 210 patients with lymphoma was selected for the study. Latent category growth modeling and one-way analysis of variance and two-by - two comparisons were performed to analyze the data for testing. Result There were three different trajectories in the operative nutrition risk index of lymphoma patients. The three trajectory categories were C1 steady decline group 44. 1% C2 rapid decline group 27. 5% and C3 low level fluctuation group 28. 4% . There were significant differences in age χ 2 = 11. 584 P = 0. 003 BMI χ 2 = 19. 661 P < 0. 001 tumor stage χ 2 = 40. 237 P < 0. 001 and synchronous radiotherapy χ 2 = 7. 593 P = 0. 022 . The quality of life difference analysis results showed that the quality of life of patients in the stable decline group was higher than that in the rapid decline group P < 0. 01 and the low fluctuation group P < 0. 01 and the quality of life of patients in the rapid decline group was higher than that in the low fluctuation group P < 0. 05 . Conclusion Medical personnel pay attention to the assessment of the level of nutritional risk index during chemotherapy for lymphoma pay attention to the patients in the rapidly declining group and the low-level fluctuation group and provide timely and necessary nutritional interventions and support which is important for correcting the risk of malnutrition and improving the nutritional status of the patients in the later stages of their lives.
2025 Vol. 12 (3): 327-333 [Abstract] ( 24 ) HTML PDF (1468 KB)  ( 12 )
334 Metabolic regulation and apoptotic mechanisms of hepatocellular carcinoma mediated by hepatic stellate cells
1,2Sun Rui,2Ma Jiayi,1,3Li Lei,2Wang Shanshan
Objective To investigate the role of hepatic stellate cells HSCs in hepatocellular carcinoma HCC . Method The study analyzed data from the GEO database GSE25097 to identify changes in HSCs expression in patients with liver cirrhosis and HCC. The LX2 cell line representing HSCs and the HepG2 cell line representing HCC were selected for in vitro experiments. The experimental group involved Transwell co-culture while the control group consisted of HepG2 cells cultured alone. After three days of culture second - generation sequencing was performed. The mechanism of HSCs ' effect on HCC was further explored using bioinformatics and flow cytometry. Result Analysis of GSE25097 data revealed a significant increase in HSCs expression in patients with liver cirrhosis P<0. 05 while a significant decrease was observed in HCC patients compared to those with cirrhosis P<0. 05 . Sequencing results indicated that the differentially expressed genes between the two groups were primarily involved in metabolism and apoptosis. Metabolism - related significantly different genes were mainly enriched in metabolic pathways and the AMPK signaling pathway with key genes including SLC11A1 GPX3 and PFKP. Apoptosis -related significantly different genes were enriched in cancer pathways and the TNF signaling pathway with key genes including PDGFB IGFBP3 FOS and DUSP1. Phenotypic experiments demonstrated that LX2 could inhibit HepG2 proliferation P<0. 05 and promote HepG2 apoptosis P<0. 05 P<0. 01 . Mitochondrial membrane potential experiments also confirmed that LX2 could promote HepG2 apoptosis P<0. 01 . Conclusion HSCs exert a direct inhibitory effect on HCC primarily by disrupting tumor cell metabolism and promoting apoptosis.
2025 Vol. 12 (3): 334-343 [Abstract] ( 35 ) HTML PDF (11245 KB)  ( 3 )
344 Construction of nutritional support needs system for nasopharyngeal carcinoma radiotherapy patients and Kano evaluation
1Fei Yanyan,1Wu Jiang,2Fu Yangshan,3Liu Qin
Objective To construct a nutritional support needs system for nasopharyngeal carcinoma radiotherapy patients that is suitable for China's national conditions and to use the Kano analysis method to clarify their demand attributes. Method Used literature analysis semi- structured interviews and Delphi method to form a nutritional support needs system for nasopharyngeal carcinoma radiotherapy patients. A questionnaire survey was conducted on 180 nasopharyngeal carcinoma radiotherapy patients at Peking University Cancer Hospital Yunnan Hospital from January to December 2023. The Kano analysis method was used to clarify the nutritional support needs of nasopharyngeal carcinoma radiotherapy patients. Result The judgment basis coefficients Ca for the two rounds of expert consultation were 0. 901 and 0. 904 respectively. The familiarity coefficients Cs for the indicators were 0. 840 and 0. 845 and the authority coefficients Cr were 0. 857 and 0. 868 respectively. A nutritional care demand indicator system for nasopharyngeal carcinoma radiotherapy patients was ultimately formed which includes 5 primary indicators and 31 secondary indicators. Among the 31 secondary indicators the Kano attribute has the highest proportion of One-dimensional Quality O with 13 41. 9% Must-be Quality M with 10 32. 3% Attractive Quality A with 6 19. 4% and Indifferent Quality I with 2 6. 4% . Conclusion The nutritional support needs system for nasopharyngeal carcinoma radiotherapy patients constructed in this study is reliable and authoritative. Kano's analysis shows that the nutritional support needs of nasopharyngeal carcinoma radiotherapy patients exhibit diversified characteristics. Medical staff should actively meet the expectations and essential attributes of patients and provide and innovate attractive attribute services to improve their medical experience.
2025 Vol. 12 (3): 344-351 [Abstract] ( 28 ) HTML PDF (1253 KB)  ( 4 )
352 Best evidence summary of nutrition management during the perioperative period in adult liver transplantation recipients
1Yang Jin,2Cheng Qiao,2Hui Na,2Zheng Meixia
Objective To integrate the best evidence of perioperative nutrition management in liver transplant recipients and provide a reference for the clinical care of perioperative liver transplant recipients. Method Computer searched the JBI evidence-based care database international Guide Collaborative Network Clinical Decision Support System Cochrane Library PubMed Medline CNKI Wanfang database and so on to obtain relevant guidelines evidence summaries systematic review and expert consensus on the nutritional management of liver transplant recipients. The search period was from January 1 2018 to October 31 2024. Two investigators evaluated the quality of the literature extracted relevant evidence and integrated it. Result 13 articles were included 4 guidelines 5 systematic reviews 4 expert consensus and 1 evidence summary . 21 pieces of evidence were summarized from 6 aspects screening and assessment of nutritional risk nutrition and management pathways energy and protein intake initiation of enteral nutrition timing and feeding speed micronutrient supplementation Nutrition management for comorbidities and hospital discharge nutrition management. Conclusion The best evidence can be selected based on individual conditions cultural background and values and the subjective will promoting and hindering factors of stakeholders so as to form a scientific and evidence-based perioperative nutrition management plan.
2025 Vol. 12 (3): 352-360 [Abstract] ( 23 ) HTML PDF (2642 KB)  ( 24 )
361 Nutrition impact symptoms and weight in head and neck cancer treated with radiotherapy a longitudinal study
1Liu Ting, 2Liu Liping
Objective To explore longitudinal changes in nutrition impact symptoms NIS among head and neck cancer HNC patients at different stages of radiotherapy RT and further analyze the impact of NIS on weight. Method A total of 123 HNC patients were investigated in the first week third week fifth week and seventh week of RT. Generalized Estimation Equation GEE was used to estimate the impact of NIS interference scores on weight. Result During the first week third week fifth week and seventh week of radiotherapy the numbers of NIS interfering with diet were 2 1 3 5 3 7 6 5 7 6 5 8 and the total interference scores were 19. 70±2. 47 24. 63±4. 47 27. 59±4. 71 28. 56±5. 13 and the mean body weights were 62. 06±9. 87 kg 61. 73±10. 2 kg 59. 79± 9. 67 kg 58. 3±9. 42 kg respectively each showing significant differences over time P<0. 001 . NIS of pain lack of energy and taste change impacted weight reduction P<0. 05 . Conclusion The number incidence and severity of NIS that interfere with diet in patients with HNC aggravate as RT progresses. NIS of pain lack of energy and taste change had significant impacts on weight loss. Medical staff should develop a holistic symptom management plan and dietary guidance program to strengthen the evaluation of effects.
2025 Vol. 12 (3): 361-366 [Abstract] ( 25 ) HTML PDF (832 KB)  ( 6 )
367 A correlational study on the relationship between serum vitamin C levels and nutritional and inflammatory markers in gastric cancer patients
1Tan Minghao,2Huang Daolai,1Zhu Guanyu,1Wen Bo,1Wei Shizhuang,1Hu Chaozhen,2Wu Xianghua
Objective To investigate the correlation between vitamin C levels nutritional indicators and inflammatory parameters in gastric cancer patients. Method 156 cases of gastric cancer patients were selected from those admitted to the First Affiliated Hospital of Guangxi Medical University between July and December 2023. Nutritional risk screening 2002 NRS 2002 and patient-generated subjective global assessment PG-SGA were used to evaluate the nutritional risk and nutritional status within 24 hours of admission. Meanwhile serum vitamin C levels and inflammatory markers were measured and the inflammatory-related indices were calculated. Single-factor analysis and multiple-variable Logistic regression analysis were performed to analyze the indicators for different vitamin C groups. Result Among the 156 gastric cancer patients 60. 26% 94 / 156 exhibited vitamin C deficiency. Among the 46. 79% 73 / 156 patients with nutritional risk 73. 97% 54 / 73 had vitamin C deficiency. According to the PG-SGA results moderate or severe malnutrition was identified in 68. 59% 107 / 156 of the patients with 70. 09% 75 / 107 exhibiting vitamin C deficiency and 82. 46% 47 / 57 of patients with severe malnutrition had vitamin C deficiency. Among the patients with high vitamin C albumin ALB prealbumin PA lymphocyte -to -monocyte ratio LMR prognostic nutritional index PNI and C- reactive protein - albumin - lymphocyte index CALLY were significantly higher than the patients with low vitamin C while NRS 2002 score PG-SGA score interleukin-6 IL-6 C-reactive protein CRP neutrophil to lymphocyte ratio NLR and systemic immune-inflammatory index SII were significantly lower than the patients with low vitamin C P< 0. 05 . Logistic regression analysis revealed that PG-SGA score IL-6 and CRP were independent risk factors for vitamin C deficiency P<0. 05 . Conclusion The proportion of gastric cancer patients with insufficient vitamin C is relatively high and patients with nutritional risk or malnutrition are more prone to vitamin C deficiency. Gastric cancer patients should regularly monitor vitamin C levels.
2025 Vol. 12 (3): 367-372 [Abstract] ( 28 ) HTML PDF (1420 KB)  ( 10 )
373 Effects of locally advanced intracavitary brachytherapy on immune function and nutritional indicators in patients with rectal adenocarcinoma
Fu Chenping, Jiang Huangang, Peng Jin, Zhou Fuxiang
Objective This study aimed to investigate the influence of intracavitary brachytherapy on immune function and nutritional indicators in patients with rectal adenocarcinoma. Method A total of 89 patients with locally advanced rectal adenocarcinoma admitted to the Oncology Department of Zhongnan Hospital of Wuhan University from May 2016 to July 2024 were included. According to the treatment regimens they were divided into the study group neoadjuvant chemoradiotherapy combined intracavitary brachytherapy n = 33 patients and the control group neoadjuvant chemoradiotherapy n = 56 patients . Peripheral blood absolute lymphocyte counts ALC and their subsets albumin and total protein levels 1 week before treatment and 1 month after the end of radiotherapy were obtained. The effects of different treatment groups on immune function lymphocytes and their subsets and nutritional indicators albumin and total protein levels were compared. Multiple linear regression was used to analyze the influencing factors of lymphocytes and their subsets 1 month after radiotherapy. Result There was no significant difference in albumin and total protein levels between the study group and control group 1 week before treatment and 1 month after the end of radiotherapy. At 1 month after the end of radiotherapy the study group had higher levels of ALC and CD8 + T cells than the control group. Similarly patients with pathologic complete response pCR showed higher levels of ALC and CD8 + T cells than patients with non-pCR. Different treatment groups were identified as independent influencing factors for ALC and CD8 + T cells 1 month after the end of radiotherapy. Conclusion Compared to the neoadjuvant chemoradiotherapy group intracavitary brachytherapy combined with neoadjuvant chemoradiotherapy can increase the number of lymphocytes and CD8 + T cells 1 month after radiotherapy improve immune function and do not increase the risk of malnutrition in rectal adenocarcinoma patients.
2025 Vol. 12 (3): 373-379 [Abstract] ( 26 ) HTML PDF (857 KB)  ( 5 )
380 The prognostic nutritional index and nutritional risk screening 2002 of lung cancer patients was analyzed by Cox proportional hazards model
Zhang Hong, Chen Zhaojun, Shi Zhenjing
Objective Exploring the predictive value of prognostic nutritional index PNI and nutritional risk screening 2002 NRS2002 in predicting the prognosis of lung cancer patients using Cox proportional hazards model analysis. Method According to the inclusion and exclusion criteria a retrospective analysis was conducted on the clinical data of 652 lung cancer patients admitted to Shanghai Pulmonary Hospital from June 2021 to June 2023. Patients were followed up for 14 months after surgery and divided into two groups based on their prognosis Survival group n = 587 and death group n = 65 . The basic situation of the two groups was compared and a single factor was used to preliminarily select candidate factors. Cox proportional hazards analysis was conducted on variables with statistical differences to establish a prediction model. Receiver operating characteristic ROC curves were drawn to test the effectiveness of the prediction model. Meanwhile it is necessary to use the Kaplan Meier survival model to analyze the relationship between different PNI and NRS 2002 scores and survival. Result After 14 months of follow-up 587 patients with 652 lung cancer patients had no progression and 65 patients died or relapsed. Compared with the survival group the death group had a higher age of 66-70 years a history of alcohol consumption TNM stage Ⅲ PNI <45 and a higher NRS 2002 score of ≥3 before treatment which was statistically significant P<0. 05 . According to Cox proportional hazards analysis TNM staging PNI<45、A NRS 2002 score of≥3 before treatment is a prognostic factor for lung cancer patients P<0. 05 . Based on these factors a prediction model was established and validated using Bootstrap method. The ROC curve area was 0. 745 and the 95%CI was 0. 680-0. 810. This model can effectively predict the prognosis of patients. Meanwhile Kaplan Meier survival analysis showed that patients with PNI≥45 had longer survival times and lower mortality rates than those with PNI <45 The survival time of patients with NRS 2002<3 points is longer than that of patients with NRS 2002 ≥3 points and the mortality rate is lower than that of patients with NRS 2002≥3 points with statistical significance P<0. 05 . Conclusion The prognosis of lung cancer patients is influenced by TNM staging NRS 2002 score and PNI score. By constructing a predictive model it is possible to timely understand the preoperative nutritional status of patients identify high-risk states and carry out targeted interventions to improve prognosis.
2025 Vol. 12 (3): 380-386 [Abstract] ( 19 ) HTML PDF (907 KB)  ( 21 )
387 A study of the effect of blood lipids on survival in patients undergoing radiotherapy for intermediate to advanced NSCLC
1Xiong Jing,2Lyu Jiahua,1,2Zhang Shichuan
Objective To investigate the effect of blood lipids on the survival prognosis of intermediate and advanced non-small cell lung cancer NSCLC radiotherapy patients. Method A retrospective analysis was performed on the clinical data of 164 patients with stage Ⅲ to Ⅳ NSCLC and dyslipidemia who received radiotherapy at Sichuan Cancer Hospital from January 2018 to May 2023. The optimal cutoff values for total cholesterol TC and triglyceride TG were determined using the receiver operating characteristic ROC curve with subsequent stratification of patients into corresponding groups. Prognostic factors were evaluated using both univariate and multivariate Cox regression models complemented by Kaplan-Meier survival analysis for statistical comparisons and clinical outcome assessment. Result The ROC curve was used to obtain the optimal cut-off values of cholesterol and triglycerides and the optimal cut-off values of TC and TG were 5. 72 mmol / L and 1. 795 mmol / L respectively. The DCR of the low cholesterol group < 5. 72 mmol / L was significantly higher than that of the high cholesterol group ≥5. 72 mmol / L P<0. 05 . Median progress free survive PFS in the low- cholesterol group was significantly better than that in the high - value group 16 vs 12 months P = 0. 0078 . However there was no statistically significant difference in median overall survival OS between the two groups 44 months vs 36 months P= 0. 1681 . Compared with the non-use group the mPFS 18 months vs 11 months P= 0. 014 and OS 54 vs 35 months P= 0. 027 were significantly longer in the lipid-lowering drug group. The mPFS 16 months of patients with decreased cholesterol levels after radiotherapy was 7 months longer than that of patients with increased cholesterol 9 months P= 0. 0215 and the OS 41 months vs 38 months was 3 months longer P = 0. 2700 . Cox multifactorial analysis suggested that tumor stage cholesterol level,trend of cholesterol change after radiotherapy and total protein were risk factors for NSCLC prognosis P < 0. 05 . Conclusion Tumor stage cholesterol level and its trend and total protein level are independent prognostic factors affecting patients with NSCLC. Pre-radiotherapy cholesterol level and the use of lipid - lowering drugs can significantly improve PFS and OS in patients with dyslipidemia undergoing radiotherapy for intermediate and advanced NSCLC and have the potential to improve survival outcomes.
2025 Vol. 12 (3): 387-397 [Abstract] ( 21 ) HTML PDF (5451 KB)  ( 15 )
398 New progress in oncology nutrition in the era of immunotherapy
Gao jie, Jiang Xiaodong, Hui Kaiyuan
Abnormal nutrition metabolism and immune imbalance permeate the entire process of tumorigenesis and development. In tumor immunotherapy immune checkpoint molecules enable tumor cells to achieve immune escape. Although T cell-based immune checkpoint inhibitor therapy is effective it faces the problems of low clinical response rate and severe side effects. Currently nutritional therapy has been recommended as a first - line treatment for tumor patients. The relationship between it and immune homeostasis suggests that nutritional intervention may affect the efficacy of tumor immunotherapy. A variety of nutritional supplements such as ω - 3 polyunsaturated fatty acids vitamins dietary fiber probiotics arginine selenium and plant extracts all have immunomodulatory effects. They can act on tumor cells and immune cells affect the tumor microenvironment and when combined with immune checkpoint inhibitors can regulate the immune response and promote the recognition and killing of tumors by immune cells. In a variety of tumor animal model experiments and some preclinical studies it has been confirmed that they can significantly affect the effect of tumor immune checkpoint inhibitor therapy. This article will review the research progress in recent years on the immunomodulatory effects of various nutritional supplements and their relationship with tumor immune checkpoint inhibitor therapy so as to provide ideas for the in-depth study of anti-tumor treatment with nutritional supplements and the combined use of immunotherapy drugs and promote the development of individualized and precise nutritional immunotherapy.
2025 Vol. 12 (3): 398-404 [Abstract] ( 35 ) HTML PDF (2882 KB)  ( 24 )
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