Zhou Xing-Wang, Dong Hui, Yang Yuan, Luo Jie-Wen, Wang Xiang, Liu Yan-Hui, Mao Qing
Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China.
Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China.
Clin Neurol Neurosurg. 2016 Dec;151:86-91. doi: 10.1016/j.clineuro.2016.10.014. Epub 2016 Oct 22.
Accumulating evidence demonstrates that prognostic nutritional index(PNI) is linked to the clinical outcome of patients with malignant tumors, but few studies had investigated the clinical significance of PNI in glioblastoma multiforme(GBM). This study aimed to clarify the association between PNI and the clinical outcome of patients with GBM.
The clinical data of 84 patients with GBM were retrospectively analyzed. PNI was calculated from the following formula: 10×serum albumin (g/dL)+0.005×total lymphocyte count (per mm). X-tile software was used to determine the cut-off of PNI and other hematological parameters. GBM patients were dichotomized as two groups based on the PNI cut-off.
The optimal PNI cut-off level was 44.4. There were 14 patients with a PNI<44.4 and 70 patients with a PNI≥44.4. The results showed that PNI score was associated with gender, serum albumin, and hemoglobin level. Univariate analysis suggested that age, extent of resection, adjuvant treatment, platelet count and PNI score were predictors of overall survival in patients with GBM. The 1- and 2-survival rates of patients with a PNI<44.4 were 28.60 and 0%, respectively, while the corresponding values for patients with a PNI≥44.4 were 52.90 and 5.70%, respectively. Based on multivariate analysis, a PNI≥44.4 (HR:0.479, 95% CI:0.235-0.975,p=0.042) remained an independent prognostic indicator for a favorable outcome of patients with GBM. Furthermore, patients with a PNI≥44.4 may have a better efficacy of adjuvant treatment than patients with a PNI<44.4 (HR:0.259, 95% CI:0.096-0.700, p=0.008).
A PNI>44.4 was an independent prognostic parameter of overall survival in patients with GBM and the efficacy of adjuvant treatment. Interventions aimed at correcting the nutritional and immune status of patients with GBM may, therefore, promote the effectiveness of adjuvant treatment and improve the survival outcomes.
越来越多的证据表明，预后营养指数（PNI）与恶性肿瘤患者的临床结局相关，但很少有研究探讨PNI在多形性胶质母细胞瘤（GBM）中的临床意义。本研究旨在阐明PNI与GBM患者临床结局之间的关联。
回顾性分析84例GBM患者的临床资料。PNI通过以下公式计算：10×血清白蛋白（g/dL）+0.005×总淋巴细胞计数（每立方毫米）。使用X-tile软件确定PNI及其他血液学参数的截断值。根据PNI截断值将GBM患者分为两组。
最佳PNI截断水平为44.4。PNI<44.4的患者有14例，PNI≥44.4的患者有70例。结果显示，PNI评分与性别、血清白蛋白和血红蛋白水平相关。单因素分析表明，年龄、切除范围、辅助治疗、血小板计数和PNI评分是GBM患者总生存的预测因素。PNI<44.4的患者1年和2年生存率分别为28.60%和0%，而PNI≥44.4的患者相应值分别为52.90%和5.70%。基于多因素分析，PNI≥44.4（HR：0.479，95%CI：0.235-0.975，p=0.0-42）仍然是GBM患者良好结局的独立预后指标。此外，PNI≥44.4的患者辅助治疗疗效可能优于PNI<44.4的患者（HR：0.259，95%CI：0.096-0.700，p=0.008）。
PNI>44.4是GBM患者总生存及辅助治疗疗效的独立预后参数。因此，旨在纠正GBM患者营养和免疫状态的干预措施可能会提高辅助治疗的有效性并改善生存结局。
