Department of Thoracic Surgery, Zhejiang Cancer Hospital, Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, People's Republic of China.
Ther Clin Risk Manag. 2014;10:1-7. doi: 10.2147/TCRM.S56159. Epub 2013 Dec 16.
The prognostic nutritional index (PNI) is related to the prognosis in many cancers; however, its role in esophageal cancer is still controversial. Further, controversy exists concerning the optimal cut-off points for PNI to predict survival. The aim of this study was to determine the prognostic value of PNI and propose the optimal cut-off points for PNI in predicting cancer-specific survival (CSS) in esophageal squamous cell carcinoma (ESCC).
This retrospective study included 375 patients who underwent esophagectomy for ESCC. The PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm(3)). With the help of the fit line on the scatter plot, we classified the patients into three categories according to the PNI, ie, >52, 42-52, and <42.
Our study showed that PNI was associated with tumor length (P=0.007), T grade (P=0.001), and N staging (P<0.001). The 5-year CSS in patients with PNI <42, 42-52, and >52 were 11.0%, 39.1%, and 55.2%, respectively (P<0.001). Multivariate analysis showed that PNI was a significant predictor of CSS (42-52 versus >52, P=0.011; <42 versus PNI >52, P<0.001).
PNI is a predictive factor for long-term survival in ESCC. The survival rate of ESCC can be discriminated between three groups, ie, PNI <42, 42-52, and >52.
预后营养指数（PNI）与许多癌症的预后相关，但在食管癌中的作用仍存在争议。此外，PNI 预测生存的最佳截断值也存在争议。本研究旨在确定 PNI 的预后价值，并提出预测食管鳞状细胞癌（ESCC）患者癌症特异性生存（CSS）的 PNI 最佳截断值。
本回顾性研究纳入了 375 例行 ESCC 切除术的患者。PNI 计算方法为 10×血清白蛋白（g/dL）+0.005×总淋巴细胞计数（每 mm(3)）。借助散点图上的拟合线，我们根据 PNI 将患者分为三组，即>52、42-52 和<42。
本研究表明，PNI 与肿瘤长度（P=0.007）、T 分级（P=0.001）和 N 分期（P<0.001）有关。PNI<42、42-52 和>52 的患者 5 年 CSS 分别为 11.0%、39.1%和 55.2%（P<0.001）。多因素分析显示，PNI 是 CSS 的显著预测因子（42-52 与>52 相比，P=0.011；<42 与 PNI>52 相比，P<0.001）。
PNI 是 ESCC 患者长期生存的预测因素。ESCC 患者的生存率可分为三组，即 PNI<42、42-52 和>52。
