预后营养指数的降低与接受新辅助化疗的胃癌患者较差的长期预后相关。
A decrease in the prognostic nutritional index is associated with a worse long-term outcome in gastric cancer patients undergoing neoadjuvant chemotherapy.
作者信息
Migita Kazuhiro, Matsumoto Sohei, Wakatsuki Kohei, Ito Masahiro, Kunishige Tomohiro, Nakade Hiroshi, Kitano Mutsuko, Nakatani Mitsuhiro, Kanehiro Hiromichi
机构信息
Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.
出版信息
Surg Today. 2017 Aug;47(8):1018-1026. doi: 10.1007/s00595-017-1469-y. Epub 2017 Mar 1.
PURPOSE
The aim of this study was to evaluate the prognostic impact of the prognostic nutritional index (PNI) in gastric cancer patients undergoing neoadjuvant chemotherapy (NAC).
METHODS
This study reviewed 54 patients with gastric cancer who underwent NAC and a subsequent R0 gastrectomy. The PNI before starting NAC and before gastrectomy were calculated using the following formula: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm). A multivariate analysis was performed to identify the predictors of overall survival (OS).
RESULTS
The mean pre-NAC and preoperative PNI were 48.3 ± 5.1 and 48.2 ± 4.7, respectively (p = 0.934). The PNI decreased after NAC in 31 patients (57.4%). The pre-NAC PNI and preoperative PNI were not significantly associated with the OS rate. The 3-year OS rate in patients with the decreased PNI values was significantly lower than that in the patients whose PNI values were either maintained or increased (41 vs. 76.4%, p = 0.003). A multivariate analysis revealed that a decreased PNI value was an independent predictor of a poor OS (p = 0.006).
CONCLUSIONS
Decreased PNI values were associated with worse long-term outcomes in gastric cancer patients undergoing NAC.
目的
本研究旨在评估预后营养指数（PNI）对接受新辅助化疗（NAC）的胃癌患者的预后影响。
方法
本研究回顾了54例接受NAC及后续R0胃切除术的胃癌患者。使用以下公式计算开始NAC前和胃切除术前的PNI：10×血清白蛋白（g/dl）+0.005×总淋巴细胞计数（每立方毫米）。进行多因素分析以确定总生存期（OS）的预测因素。
结果
NAC前和术前PNI的平均值分别为48.3±5.1和48.2±4.7（p = 0.934）。31例患者（57.4%）在NAC后PNI下降。NAC前PNI和术前PNI与OS率无显著相关性。PNI值降低的患者3年OS率显著低于PNI值维持或升高的患者（41%对76.4%，p = 0.003）。多因素分析显示，PNI值降低是OS不良的独立预测因素（p = 0.006）。
结论
PNI值降低与接受NAC的胃癌患者较差的长期预后相关。
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