Yang Y, Gao P, Song Y, Sun J, Chen X, Zhao J, Ma B, Wang Z
Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang City 110001, PR China.
Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang City 110001, PR China.
Eur J Surg Oncol. 2016 Aug;42(8):1176-82. doi: 10.1016/j.ejso.2016.05.029. Epub 2016 Jun 1.
The clinical value of the prognostic nutritional index (PNI) in gastric cancer (GC) remains controversial. Therefore, we performed the meta-analysis to determine the prognostic and clinicopathological values of PNI in patients with GC.
A literature search was performed in the PubMed, Embase, and Web of Science databases. Hazard ratios (HRs) and odds ratios (ORs) were extracted to estimate the association of PNI with survival and clinicopathological characteristics, respectively.
Ten studies involving 3396 patients with GC were analyzed. The pooled results indicated that a low PNI was a significant predictor of poor overall survival (OS) (HR = 1.89, 95% confidence interval [CI] = 1.67-2.13, P < 0.01) and postoperative complications (OR = 1.74, 95% CI = 1.41-2.16, P < 0.01). In the subgroup analysis, a low PNI was significantly associated with poor OS in patients with GC at stage I, II and III, but not at stage IV (HR = 1.14, 95% CI = 0.84-1.55, P = 0.40). Moreover, a low PNI was significantly associated with more advanced tumor features, such as older age, deeper depth of tumor, positive lymph node metastasis, more advanced TNM stages, and positive vessel and lymphatic invasion.
PNI was a predictive indicator of survival and postoperative complications, and was associated with clinicopathological features in GC patients. However, a low PNI was not significantly associated with poor OS in patients with GC at stage IV.
预后营养指数（PNI）在胃癌（GC）中的临床价值仍存在争议。因此，我们进行了荟萃分析，以确定PNI在GC患者中的预后和临床病理价值。
在PubMed、Embase和Web of Science数据库中进行文献检索。提取风险比（HRs）和比值比（ORs），分别评估PNI与生存及临床病理特征之间的关联。
分析了10项涉及3396例GC患者的研究。汇总结果表明，低PNI是总生存期（OS）差（HR = 1.89，95%置信区间[CI] = 1.67 - 2.13，P < 0.01）和术后并发症（OR = 1.74，95% CI = 1.41 - 2.16，P < 0.01）的显著预测指标。在亚组分析中，低PNI与I、II和III期GC患者的OS差显著相关，但与IV期患者无关（HR = 1.14，95% CI = 0.84 - 1.55，P = 0.40）。此外，低PNI与更晚期的肿瘤特征显著相关，如年龄较大、肿瘤深度更深、淋巴结转移阳性、TNM分期更晚以及血管和淋巴管侵犯阳性。
PNI是生存和术后并发症的预测指标，与GC患者的临床病理特征相关。然而，低PNI与IV期GC患者的OS差无显著关联。
