Tokunaga Ryuma, Sakamoto Yasuo, Nakagawa Shigeki, Izumi Daisuke, Kosumi Keisuke, Taki Katsunobu, Higashi Takaaki, Miyata Tatsunori, Miyamoto Yuji, Yoshida Naoya, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Int J Clin Oncol. 2017 Aug;22(4):740-748. doi: 10.1007/s10147-017-1102-5. Epub 2017 Feb 17.
Various systemic inflammatory and nutritional scores have been reported to predict postoperative outcomes. This study aimed to investigate the best systemic inflammatory and nutritional scores in colorectal cancer (CRC) patients who underwent potentially curative resection.
We evaluated 468 consecutive CRC patients in this study. Comparisons of systemic inflammatory and nutritional scores, including the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), prognostic index (PI), prognostic nutritional index (PNI), and modified Glasgow prognostic score (mGPS), were performed using univariate/multivariate analyses for patient survival.
The PNI and mGPS, but not the NLR, PLR, and PI, were significantly associated with overall and relapse-free survival. The mGPS, but not the PNI, was strongly correlated with TNM stage (P < 0.001). Cox multivariate analysis showed that both the PNI and mGPS were exclusive independent prognostic factors for both overall and relapse-free survival (P < 0.001). Furthermore, the PNI status predicted patient survival more clearly than the mGPS in combination with TNM stage.
This study suggests that the PNI and mGPS are useful predictive scores in CRC patients who undergo potentially curative resection, especially the PNI in combination with TNM stage. Routine evaluation of the host status using the scores may be useful in CRC treatment.
据报道，多种全身炎症和营养评分可预测术后结果。本研究旨在调查接受根治性切除的结直肠癌（CRC）患者中最佳的全身炎症和营养评分。
本研究评估了468例连续的CRC患者。对全身炎症和营养评分进行比较，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、预后指数（PI）、预后营养指数（PNI）和改良格拉斯哥预后评分（mGPS），采用单因素/多因素分析患者生存率。
PNI和mGPS与总生存率和无复发生存率显著相关，而NLR、PLR和PI则不然。mGPS与TNM分期密切相关，而PNI则不然（P < 0.001）。Cox多因素分析显示，PNI和mGPS均是总生存率和无复发生存率的独立预后因素（P < 0.001）。此外，PNI状态比mGPS结合TNM分期更能清楚地预测患者生存率。
本研究表明，PNI和mGPS是接受根治性切除的CRC患者有用的预测评分，尤其是PNI结合TNM分期。使用这些评分对宿主状态进行常规评估可能对CRC治疗有用。
