The Correlation Between Body Mass Index With Prognosis Of Patients With Advanced Gastric Cancer And A Clinical Study On The Effect Of Traditional Chinese Medicine On The Quality Of Life Of Patients With Gastric Cancer

Objective:To explore the correlation between BMI and prognosis in patients with advanced gastric cancer,to find the risk factors for survival and prognosis of patients with advanced gastric cancer,to identify the clinical high-risk population,and to guide clinical treatment.To study the impact of traditional Chinese medicine on the quality of life of patients with gastric cancer,and explore whether traditional Chinese medicine can improve the quality of life of patients with anti-tumor treatment such as surgery and radiotherapy and chemotherapy,and provide evidence for the clinical use of traditional Chinese medicine.Method:Study 1:Retrospectively analyzed 149 patients with advanced gastric cancer who were hospitalized in the oncology department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2017 to December2018,and recorded the age,sex,height,weight and KPS score of the patients,Surgery history,chemotherapy history,CA72-4,CA199,AFP,CEA,CYFRA21-1,WBC,RBC,HGB,PLT,NEUT,LYMPH,BUN,CR,ALB,ALT,AST,GGT,ALP,TBIL and other clinical data.The follow-up time and survival outcome of patients were obtained through regular review and telephone follow-up.SPSS22.0 software was used to record and analyze the data.The correlation analysis used binary Logistics regression analysis,the single-factor survival analysis used Kaplan-Meier curve and Log-Rank test,and the multi-factor analysis used Cox proportional hazard regression model to screen out the independent risk factors for survival time of patients with advanced gastric cancer.Study 2:Collect gastric cancer patients who were treated in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from March 2018 to September 2019,and screen out gastric cancer that has completed surgery,radiotherapy and chemotherapy treatment and entered the stage of pure Chinese medicine treatment There were 50 patients in total.Record quality of life scores before and after treatment(KPS score,QLQ-C30,QLQ-STO22),BMI,T lymphocyte subsets,RBC,HGB,TP,ALB,CR,BUN,ALT,AST,GGT.SPSS22.0 software was used to record and analyze the data,and the difference between the data before and after treatment was analyzed normally.Data that matched the normal distribution were tested using paired samples,and data that did not conform to the normal distribution were tested using the non-parametric test Wilcoxon test.Compare whether there are obvious differences between the factors before and after treatment.Results:1.Correlation analysis showed that BMI,KPS score,FER,CYFRA21-1 are independent risk factors for one-year survival,BMI<18.5kg/m~2,KPS<70,FER>274.7ng/ml,CYFRA21-1>2.08ng/ml is a risk factor for one-year survival.2.The results of univariate survival analysis showed that the history of chemotherapy,BMI,KPS score,ALB,GGT,ALP,CA199,AFP,CYFRA21-1,FER were correlated with patient OS(P<0.05),and further COX multivariate regression analysis,BMI<18.5kg/m~2(P<0.001,HR=0.583,95%CI:0.431-0.787),KPS score<70(P<0.05,HR=0.662,95.0%CI:0.441-0.993),ALB<30g/L(P<0.05,HR=0.744,95%CI:0.593-0.932),CA199>37U/ml(P<0.05,HR=1.564,95%CI:1.030-2.375),CYFRA21-1>2.08ng/ml(P<0.05,HR=1.818,95%CI:1.043-3.168)is an independent risk factor affecting patients with advanced gastric cancer.3.Differences in observation indexes before and after treatment with traditional Chinese medicine:(1)BMI:BMI before treatment was 20.94±2.93kg/m~2,BMI after treatment was 21.55±2.69 kg/m~2,and BMI after treatment was significantly higher than BMI before treatment(P<0.001).(2)KPS score:KPS score after treatment was significantly higher than that before treatment(P<0.001).(3)QLQ-C30 scale:after treatment,the physical field,role field,emotional field,overall health status/quality of life were significantly higher than before treatment;after treatment,fatigue,nausea,shortness of breath,appetite,constipation,diarrhea,and economic aspects were significantly lower It was lower than before treatment(P<0.05),but there was no statistically significant difference in cognitive field,social field,pain and insomnia before and after treatment(P>0.05).(4)QLQ-STO22 scale:after treatment,dysphagia,stomach pain,reflux,restricted diet,dry mouth,taste are significantly higher than before treatment(P<0.05),but there is no difference in anxiety,physical appearance and hair loss before and after treatment Statistical significance(P>0.05)(5)Nutritional status indicators:ALB after treatment was significantly higher than before treatment,the difference was statistically significant(P=0.001),the difference between RBC,HGB,TP before and after treatment was not statistically significant(P>0.05).(6)T lymphocyte subsets:After treatment,CD3+/CD8+was significantly higher than before treatment(P=0.002),and there was no significant difference between CD3+,CD3+/CD4+before and after treatment(P>0.05).(7)Safety index:Differences in liver and kidney function related indexes before and after treatment are not statistically significant(P>0.05)Conclusion:1.BMI<18.5kg/m~2,KPS score<70,FER>274.7ng/ml,CYFRA21-1>2.08ng/ml is a risk factor for one-year survival of patients with advanced gastric cancer.2.BMI,KPS score,ALB,CA199,CYFRA21-1 are independent risk factors for OS in patients with advanced gastric cancer.Patients with BMI<18.5kg/m~2,KPS score<70,ALB<30g/L,CA199>37U/ml,CYFRA21-1>2.08ng/ml have a poor survival prognosis.3.For patients with gastric cancer who have completed the course of surgery and radiotherapy and chemotherapy,Chinese medicine can increase BMI,improve the quality of life of the patients,improve the nutritional status of the patients,enhance the immune function of the patients,and have no obvious toxic and side effects on the patients.