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已发表论文
肺癌患者预后营养指数与身心症状群的交叉滞后分析：一项纵向研究
Authors Li T, Wu Y, Yang Q, Zheng Y, Xu Y, Lin H
Received 24 July 2025
Accepted for publication 23 December 2025
Published 31 December 2025 Volume 2025:17 Pages 3349—3358
DOI https://doi.org/10.2147/CMAR.S556061
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Shari Youngblood
Tingting Li,1,* Ying Wu,1,* Qun Yang,1,* Yuanyuan Zheng,1 Yunyun Xu,1 Huan Lin2
1Department of Cardiothoracic Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tingting Li, Department of Cardiothoracic surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210029, People’s Republic of China, Email Ltt3389@163.com
Objective: To investigate the development trend of prognostic nutritional index and psychosomatic symptom clusters (multidimensional fatigue, generalized anxiety, difficulty in emotional regulation) in patients with lung cancer, and to analyze their correlation and predictive relationship.
Methods: One hundred and eighty-five patients with lung cancer were selected as the research objects using the convenience sampling method. The prognostic nutritional index and psychosomatic symptom cluster were followed up at T1, T2, and T3 after the operation. Repeated measures ANOVA and cross - lag model were used for statistical testing.
Results: A total of 185 questionnaires were distributed, and 7 invalid questionnaires were excluded, with an effective recovery rate of 96.22%. The results of repeated measurement showed the scores of prognostic nutritional index (F = 3.342, P = 0.031), multidimensional fatigue (F = 5.362, P < 0.001), generalized anxiety (F = 6.003, P < 0.001), and emotional regulation difficulties (F = 0.885, P = 0.420) at the three time points. Results of the cross - lag model: The level of prognostic nutritional index negatively predicted multidimensional fatigue symptoms (T1→T2: β = - 0.415, P = 0.003; T2→T3: β = - 0.433, P = 0.005) and generalized anxiety symptoms (T1→T2: β = - 0.364, P = 0.007; T2→T3: β = - 0.350, P = 0.012). The prognostic nutritional index at T2 significantly and negatively predicted emotional adjustment difficulties at T3 (T1→T2: β = 0.158, P = 0.151; T2→T3: β = - 0.233, P = 0.024). While in the psychosomatic symptom cluster, only multidimensional fatigue negatively predicted the prognostic nutritional index at the next node (T1→T2: β = - 0.314, P = 0.003; T2→T3: β = - 0.342, P = 0.001).
Conclusion: The prognostic nutritional index of patients with lung cancer after surgery is closely related to the psychosomatic symptom cluster. The prognostic nutritional index has a negative predictive effect on the psychosomatic symptom cluster, and the multidimensional fatigue symptom also has a negative predictive effect on the prognostic nutritional index.
Keywords: lung cancer, prognostic nutritional index, psychosomatic symptom clusters, multidimensional fatigue, generalized anxiety, difficulty in emotional regulation, relevance, cross - lag model, nursing
1Department of Cardiothoracic Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tingting Li, Department of Cardiothoracic surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210029, People’s Republic of China, Email Ltt3389@163.com
Objective: To investigate the development trend of prognostic nutritional index and psychosomatic symptom clusters (multidimensional fatigue, generalized anxiety, difficulty in emotional regulation) in patients with lung cancer, and to analyze their correlation and predictive relationship.
Methods: One hundred and eighty-five patients with lung cancer were selected as the research objects using the convenience sampling method. The prognostic nutritional index and psychosomatic symptom cluster were followed up at T1, T2, and T3 after the operation. Repeated measures ANOVA and cross - lag model were used for statistical testing.
Results: A total of 185 questionnaires were distributed, and 7 invalid questionnaires were excluded, with an effective recovery rate of 96.22%. The results of repeated measurement showed the scores of prognostic nutritional index (F = 3.342, P = 0.031), multidimensional fatigue (F = 5.362, P < 0.001), generalized anxiety (F = 6.003, P < 0.001), and emotional regulation difficulties (F = 0.885, P = 0.420) at the three time points. Results of the cross - lag model: The level of prognostic nutritional index negatively predicted multidimensional fatigue symptoms (T1→T2: β = - 0.415, P = 0.003; T2→T3: β = - 0.433, P = 0.005) and generalized anxiety symptoms (T1→T2: β = - 0.364, P = 0.007; T2→T3: β = - 0.350, P = 0.012). The prognostic nutritional index at T2 significantly and negatively predicted emotional adjustment difficulties at T3 (T1→T2: β = 0.158, P = 0.151; T2→T3: β = - 0.233, P = 0.024). While in the psychosomatic symptom cluster, only multidimensional fatigue negatively predicted the prognostic nutritional index at the next node (T1→T2: β = - 0.314, P = 0.003; T2→T3: β = - 0.342, P = 0.001).
Conclusion: The prognostic nutritional index of patients with lung cancer after surgery is closely related to the psychosomatic symptom cluster. The prognostic nutritional index has a negative predictive effect on the psychosomatic symptom cluster, and the multidimensional fatigue symptom also has a negative predictive effect on the prognostic nutritional index.
Keywords: lung cancer, prognostic nutritional index, psychosomatic symptom clusters, multidimensional fatigue, generalized anxiety, difficulty in emotional regulation, relevance, cross - lag model, nursing