术前预后营养指数对贲门腺癌患者术后预后评价的价值
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摘要
目的:研究术前预后营养指数(PNI)对贲门腺癌(GCA)术后预后的评价价值。方法:回顾性分析河南省安阳市肿瘤医院接受根治术治疗的GCA患者627例的临床资料。根据术前1周内检查的血清白蛋白水平和淋巴细胞数计算PNI。结果:PNI判定术后5 a生存的ROC曲线下面积为0. 650,最佳截断值为45. 5; PNI≥45. 5者375例,<45. 5者252例。Cox回归结果显示,PNI <45. 5是GCA患者术后预后的独立危险因素,HR(95%CI)为2. 645(2. 183～3. 205)。结论:术前PNI可用于GCA患者术后预后的判定,PNI≥45. 5的患者预后相对较好。
Aim: To explore the value of prognostic nutritional index( PNI) for assessing postoperation prognosis of the patients with gastric cardia adenocarcinoma( GCA). Methods: The data of 627 patients with GCA treated by radical resection from Anyang tumor hospital in Henan Province,were retrospectively analyzed. PNI was calculated based on the level of albumin and the number of lymphocytes during the first week before surgery. Results: The area under the curve of the ROC of PNI for diagnosis of GCA postoperation prognosis was 0. 650,the optimal cut-off value was 45. 5,and there were 375 patients with PNI≥45. 5 and 252 patients with PNI< 45. 5. The results of Cox regression showed that PNI < 45. 5 were independent factor affecting the prognosis of GCA patients,and HR( 95% CI) was 2. 645( 2. 183-3. 205). Conclusion: Preoperative PNI is associated with postoperative prognosis of patients with GCA,and the prognosis of patients with PNI≥45. 5 may be relatively good.
Aim: To explore the value of prognostic nutritional index( PNI) for assessing postoperation prognosis of the patients with gastric cardia adenocarcinoma( GCA). Methods: The data of 627 patients with GCA treated by radical resection from Anyang tumor hospital in Henan Province,were retrospectively analyzed. PNI was calculated based on the level of albumin and the number of lymphocytes during the first week before surgery. Results: The area under the curve of the ROC of PNI for diagnosis of GCA postoperation prognosis was 0. 650,the optimal cut-off value was 45. 5,and there were 375 patients with PNI≥45. 5 and 252 patients with PNI< 45. 5. The results of Cox regression showed that PNI < 45. 5 were independent factor affecting the prognosis of GCA patients,and HR( 95% CI) was 2. 645( 2. 183-3. 205). Conclusion: Preoperative PNI is associated with postoperative prognosis of patients with GCA,and the prognosis of patients with PNI≥45. 5 may be relatively good.
引文
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[18]YANG Y,GAO P,SONG Y,et al.The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer:a meta-analysis[J].Eur J Surg Oncol,2016,42(8):1176
[19]TOKUNAGA R,SAKAMOTO Y,NAKAGAWA S,et al.Prognostic nutritional index predicts severe complications,recurrence,and poor prognosis in patients with colorectal cancer undergoing primary tumor resection[J].Dis Colon Rectum,2015,58(11):1048
[2]LAGERGREN J,SMYTH E,CUNNINGHAM D,et al.Oesophageal cancer[J].Lancet,2017,390(10110):2383
[3]SUN P,ZHANG F,CHEN C,et al.Comparison of the prognostic values of various nutritional parameters in patients with esophageal squamous cell carcinoma from Southern China[J].J Thorac Dis,2013,5(4):484
[4]POZIOMYCK AK,WESTON AC,LAMEU EB,et al.Preoperative nutritional assessment and prognosis in patients with foregut tumors[J].Nutr Cancer,2012,64(8):1174
[5]BUZBY GP,MULLEN JL,MATTHEWS DC,et al.Prognostic nutritional index in gastrointestinal surgery[J].Am JSurg,1980,139(1):160
[6]ONODERA T,GOSEKI N,KOSAKI G.Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients[J].Nihon Geka Gakkai Zasshi,1984,85(9):1001
[7]ZHAO Y,XU P,KANG H,et al,et al.Prognostic nutritional index as a prognostic biomarker for survival in digestive system carcinomas[J].Oncotarget,2016,7(52):86573
[8]PINATO DJ,NORTH BV,SHARMA R.A novel,externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma:the prognostic nutritional index(PNI)[J].Br J Cancer,2012,106(8):1439
[9]CUI J,CHEN S,BO Q,et al.Preoperative prognostic nutritional index and nomogram predicting recurrence-free survival in patients with primary non-muscle-invasive bladder cancer without carcinoma in situ[J].Onco Targets Ther,2017,10:5541
[10]HARAGA J,NAKAMURA K,OMICHI C,et al.Pretreatment prognostic nutritional index is a significant predictor of prognosis in patients with cervical cancer treated with concurrent chemoradiotherapy[J].Mol Clin Oncol,2016,5(5):567
[11]ZHOU XW,DONG H,YANG Y,et al.Significance of the prognostic nutritional index in patients with glioblastoma:a retrospective study[J].Clin Neurol Neurosurg,2016,151:86
[12]WEN J,BEDFORD M,BEGUM R,et al.The value of inflammation based prognostic scores in patients undergoing surgical resection for oesophageal and gastric carcinoma[J].J Surg Oncol,2018,117(8):1697
[13]CRUMLEY ABC,STUART RC,MCKERNAN M,et al.Is hypoalbuminemia an independent prognostic factor in patients with gastric cancer?[J].World J Surg,2010,34(10):2393
[14]ERDMAN SE,POUTAHIDIS T.Roles for inflammation and regulatory T cells in colon cancer[J].Toxicol Pathol,2010,38(1):76
[15]LAKY B,JANDA M,BAUER J,et al.Malnutrition among gynaecological cancer patients[J].Eur J Clin Nutr,2007,61(5):642
[16]GAO YH,ZHOU SF,JIANG WQ,et al.Effects of ganopoly(a Ganoderma lucidum polysaccharide extract)on the immune functions in advanced-stage cancer patients[J].Immunol Invest,2003,32(3):201
[17]RAY-COQUARD I,CROPET C,VAN GLABBEKE M,et al.Lymphopenia as a prognostic factor for overall survival in advanced carcinomas,sarcomas,and lymphomas[J].Cancer Res,2009,69(13):5383
[18]YANG Y,GAO P,SONG Y,et al.The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer:a meta-analysis[J].Eur J Surg Oncol,2016,42(8):1176
[19]TOKUNAGA R,SAKAMOTO Y,NAKAGAWA S,et al.Prognostic nutritional index predicts severe complications,recurrence,and poor prognosis in patients with colorectal cancer undergoing primary tumor resection[J].Dis Colon Rectum,2015,58(11):1048