Study On Prognosis Of Lung Cancer Patientsand Quality Of Life In The Third Month After Surgery By Prognostic Nutritional Index And NRS 2002 Scores

Object To evaluate the preoperative nutritional status of patients with lung cancer surgery by PNI and NRS 2002,and to compare their effects on prognosis and quality of life in the third month after surgery.Method A total of 172 patients with lung cancer diagnosed from January 2017 to October 2017 in the Department of Thoracic Surgery,Anhui Provincial Hospital were enrolled.The Prognostic Nutrition Index(PNI)and Nutritional Risk Screening 2002(NRS 2002)were used to evaluation the preoperative nutritional status of lung cancer patients,which were divided into high/low PNI group and no nutritional risk/nutritional risk group,compare the effects of two nutritional status assessment methods on patient prognosis;the European Organization for Research and Treatment(EORTC)QLQC30 and QLQ-LC13 were used to score the quality of life of the patients,and the two nutritional status assessment methods were compared to the life of the subjects in the third month after surgery.The difference in quality.The PNI value was calculated from the test results within 1 week before surgery.PNI was measured by serum albumin(ALB,g/L)and lymphocyte count(TLC,× 109 /L)by formula(PNI=ALB+5×TLC).The patients were divided into high PNI group and low PNI group with a cut-off point of 48.Nutritional risk screening was performed at admission.Patients with a NRS 2002 total score of ≥3 had a nutritional risk,and those with a score of <3 had no nutritional risk.Results The age of patients in the low PNI group/nutrition risk group was higher than those in the high PNI group/no nutritional risk group,and the difference was statistically significant(P<0.05).There were significant differences in number of lymph node metastasis,TNM stage,postoperative hospital stay and chest lead time between high and low PNI patients(P<0.05).The number of lymph node metastasis and late TNM stage in the low PNI group were higher than in the high PNI group,and the postoperative hospital stay and chest lead time were longer than those in the high PNI group.The postoperative complication rate of high/low PNI patients was11.01%/23.81%,respectively.Statistical significance(P<0.05).NRS2002 group under the chest lead time,TNM stage,postoperative adjuvant treatment,the difference was statistically significant(P<0.05).The late TNM stage and postoperative adjuvant treatment in the nutrition risk group were higher than in the no nutrition risk group,and chest lead time was longer than that in the no nutrition risk group.The difference of no nutritional risk/nutritional risk of postoperative complications was 11.89%/34.48%,and the difference was statistically significant(P<0.05).The sensitivity of the two nutritional assessment methods was the same in predicting postoperative complications of lung cancer.In terms of specificity,PNI(85.5%)was higher than NRS 2002 score(67.5%),but there was no statistical difference(P>0.05).The scores of cognitive function and total QOL were significantly higher in the high PNI group/no nutritional risk group than in the low PNI group/nutrition risk group,in loss of appetite,constipation,cough,hemoptysis,shortness of breath,difficulty swallowing,hand The scores of shoulder/shoulder pain were significantly lower than those of the low PNI group/nutrition risk group,and the difference was statistically significant(P<0.05).In the low PNI group/nutrition risk group,digestive symptoms(appetite loss,constipation),shortness of breath,and total QOL were higher in the four dimensions,and the difference was statistically significant(P<0.05).There was no significant change in the role,social function and emotional function index of the two nutritional assessment methods(P>0.05).Multiple linear regression analysis of the quality of life of the study showed that PNI and NRS2002 scores were important factors influencing the quality of life of postoperative patients with lung cancer.Conclusion The nutritional status can affect the prognosis of lung cancer patients and the quality of life at the third month after surgery to some extent.There was no significant difference in predicting the postoperative complications of lung cancer patients,the specificity of the prognostic nutritional index was higher than that of NRS2002.In view of the simplicity and convenience of the two evaluation methods,it has certain clinical application value.