Mohri Tomomi, Mohri Yasuhiko, Shigemori Tsunehiko, Takeuchi Kenji, Itoh Yoshiyuki, Kato Toshio
Department of Surgery, Toyama Hospital, Tsu city, Mie, 514-0043, Japan.
Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu city, Mie, 514-0875, Japan.
World J Surg Oncol. 2016 Jun 27;14(1):170. doi: 10.1186/s12957-016-0920-7.
Prognostic nutritional index has been shown to be a prognostic marker for various solid tumors. However, few studies have investigated the impact of the prognostic nutritional index on survival of patients with breast cancer. The aim of this study was to investigate the impact of the prognostic nutritional index on the long-term outcomes in patients with breast cancer.
This study reviewed the medical records of 212 patients with breast cancer who underwent mastectomy. The prognostic nutritional index was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm(3)). Receiver operating characteristic curve analysis was performed to determine the cutoff value of the prognostic nutritional index. The survival curves were calculated by the Kaplan-Meier method. Differences between the curves were analyzed by the log-rank test. Multivariate Cox proportional hazard model was used to evaluate the prognostic significance of prognostic nutritional index in patients with breast cancer.
The mean prognostic nutritional index just before the operation was 51.9, and the median follow-up after surgery was 47.7 months. The optimal cutoff value of the prognostic nutritional index for predicting the overall survival was 52.8 from the receiver operating characteristic curve analysis. The 5-year overall survival rate was 98.3 % in the prognostic nutritional index >52.8 and 92.0 % in the prognostic nutritional index <52.8 (P = 0.013). In the multivariate analysis, a low prognostic nutritional index was an independent predictor for poor overall survival (HR, 5.88; 95 % CI, 1.13-108.01; P = 0.033).
The prognostic nutritional index is a simple and useful marker for predicting the long-term outcomes of breast cancer patients, independent of the tumor stage.
预后营养指数已被证明是多种实体瘤的预后标志物。然而，很少有研究探讨预后营养指数对乳腺癌患者生存的影响。本研究的目的是探讨预后营养指数对乳腺癌患者长期预后的影响。
本研究回顾了212例行乳房切除术的乳腺癌患者的病历。预后营养指数的计算方法为10×血清白蛋白（g/dl）+0.005×总淋巴细胞计数（每立方毫米）。进行受试者工作特征曲线分析以确定预后营养指数的临界值。生存曲线采用Kaplan-Meier法计算。曲线间差异采用对数秩检验分析。多变量Cox比例风险模型用于评估预后营养指数在乳腺癌患者中的预后意义。
术前平均预后营养指数为51.9，术后中位随访时间为47.7个月。根据受试者工作特征曲线分析，预测总生存的预后营养指数最佳临界值为52.8。预后营养指数>52.8的患者5年总生存率为98.3%，预后营养指数<52.8的患者为92.0%（P=0.013）。在多变量分析中，低预后营养指数是总生存不良的独立预测因素（HR，5.88；95%CI，1.13-108.01；P=0.033）。
预后营养指数是预测乳腺癌患者长期预后的一个简单且有用的标志物，与肿瘤分期无关。
