Fu Yan, Chen Shu-Wei, Chen Shi-Qi, Ou-Yang Dian, Liu Wei-Wei, Song Ming, Yang An-Kui, Zhang Quan
From the Department of Head and Neck Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China.
Medicine (Baltimore). 2016 Mar;95(11):e2962. doi: 10.1097/MD.0000000000002962.
Pinato prognostic nutritional index (PNI) adequately predicts long-term outcomes of various malignancies. However, its value in predicting outcomes in laryngeal squamous cell carcinoma (LSCC) is unknown. All patients newly diagnosed with LSCC presenting to the Department of Head and Neck Oncology at Sun Yat-sen University Cancer Center between January 1, 1990 and July 31, 2010 were eligible. The PNI was calculated as serum albumin (g/L) + 5 × total lymphocyte count/L. The Cutoff Finder software program was used to classify the patients into 3 groups for which the PNI score was at least 70% sensitive, at least 70% specific, or equivocal. Cancer-specific survival was estimated using the Kaplan-Meier method, and predictors were assessed with Cox regression analysis. Median time between surgery and PNI administration for the 975 eligible patients was 83 months. Index score groups were significantly associated with age, T stage, TNM stage, and type of surgery. Five-year CSS and OS were 57.3% and 56.6% in patients with PNI scores below 48.65 (low-probability of survival), 72.8% and 71.3% with scores between 48.65 and 56.93 (moderate-probability of survival), and 77.6% and 75.3% with scores above 56.93 (high-probability of survival); 10-year CSS and OS were 44.2% and 42.7%, 61.6% and 55.6%, 68.3% and 63.5%, respectively. The PNI score groups significantly predicted CSS and OS (P < 0.001). The PNI is an inexpensive and readily available score that predicted survival in patients with LSCC after curative laryngectomy.
皮纳托预后营养指数(PNI)能够充分预测各种恶性肿瘤的长期预后。然而,其在预测喉鳞状细胞癌(LSCC)预后方面的价值尚不清楚。所有于1990年1月1日至2010年7月31日期间在中山大学肿瘤防治中心头颈肿瘤科新诊断为LSCC的患者均符合条件。PNI的计算方法为血清白蛋白(g/L)+5×总淋巴细胞计数/L。使用Cutoff Finder软件程序将患者分为3组,其PNI评分至少70%敏感、至少70%特异或不明确。采用Kaplan-Meier法估计癌症特异性生存率,并通过Cox回归分析评估预测因素。975例符合条件的患者手术与PNI测定之间的中位时间为83个月。指数评分组与年龄、T分期、TNM分期和手术类型显著相关。PNI评分低于48.65(低生存概率)的患者5年癌症特异性生存率(CSS)和总生存率(OS)分别为57.3%和56.6%,评分在48.65至56.93之间(中等生存概率)的患者为72.8%和71.3%,评分高于56.93(高生存概率)的患者为77.6%和75.3%;10年CSS和OS分别为44.2%和42.7%、61.6%和55.6%、68.3%和63.5%。PNI评分组显著预测了CSS和OS(P<0.0