Chen Kai-Lin, Liu Yan-Hui, Li Wen-Yu, Chen Jie, Gu Yang-Kui, Geng Qi-Rong, Jiang Wen-Qi, Huang Hui-Qiang, Lin Tong-Yu, Xia Zhong-Jun, Cai Qing-Qing
Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dong Feng RD East, Guangzhou, 510060, China.
Ann Hematol. 2015 Aug;94(8):1389-400. doi: 10.1007/s00277-015-2361-8. Epub 2015 Apr 15.
The prognostic nutritional index (PNI), an indicator of nutritional status and systemic inflammation, is associated with survival in several types of tumors. The prognostic value of the PNI in lymphoma remains unclear. The present study aimed to evaluate the prognostic significance of the PNI in patients with extranodal natural killer/T cell lymphoma, nasal type (ENKTL). This retrospective study in two institutions was comprised of 177 patients with newly diagnosed ENKTL. Patients with a combined albumin (g/L) + 5 × total lymphocyte count × 10(9)/l ≥ 45 were allocated a PNI score of 0. Patients in whom this total was <45 were allocated a score of 1. Patients with a pretreatment PNI score of 1 had more adverse clinical features, lower complete remission rates (p = 0.005), and worse overall survival (OS, p < 0.001) and progression-free survival (p = 0.004) compared with those with a PNI score of 0. Multivariate analysis showed that the PNI (p < 0.001) and tumor mass ≥5 cm (p < 0.001) were independent predictors of worse OS. The PNI was predictive in extranasal disease and nasal disease (both p < 0.05). The PNI could differentiate low-risk patients as classified according to the International Prognostic Index and Prognosis Index for peripheral T cell lymphoma scoring, as well as patients in a different category using the Korean Prognostic Index scores with different survival outcomes (all p < 0.05). The PNI is a powerful predictor of survival in ENKTL. Nutritional status and inflammatory responses at diagnosis might play an important role in survival in patients with ENKTL.
预后营养指数（PNI）是营养状况和全身炎症的指标，与多种肿瘤的生存率相关。PNI在淋巴瘤中的预后价值尚不清楚。本研究旨在评估PNI在鼻型结外自然杀伤/T细胞淋巴瘤（ENKTL）患者中的预后意义。这项在两家机构开展的回顾性研究纳入了177例新诊断的ENKTL患者。白蛋白（g/L）+5×总淋巴细胞计数×10⁹/L≥45的患者PNI评分为0。该总和<45的患者评分为1。与PNI评分为0的患者相比，预处理PNI评分为1的患者具有更多不良临床特征、更低的完全缓解率（p = 0.005）以及更差的总生存期（OS，p < 0.001）和无进展生存期（p = 0.004）。多因素分析显示，PNI（p < 0.001）和肿瘤肿块≥5 cm（p < 0.001）是OS较差的独立预测因素。PNI在鼻外疾病和鼻疾病中均具有预测价值（均p < 0.05）。PNI能够区分根据国际预后指数和外周T细胞淋巴瘤预后指数评分分类的低风险患者，以及使用韩国预后指数评分处于不同类别且生存结果不同的患者（均p < 0.05）。PNI是ENKTL患者生存的有力预测指标。诊断时的营养状况和炎症反应可能在ENKTL患者的生存中起重要作用。
