Saito Hiroaki, Kono Yusuke, Murakami Yuki, Kuroda Hirohiko, Matsunaga Tomoyuki, Fukumoto Yoji, Osaki Tomohiro
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
Langenbecks Arch Surg. 2017 May;402(3):501-507. doi: 10.1007/s00423-017-1572-y. Epub 2017 Mar 15.
Blood analytes are easily used in routine clinical practice. Tumor markers (TMs) are useful in diagnosing, treating, and predicting prognosis of gastric cancer (GC). The prognostic nutritional index (PNI) was also recently found to be useful in predicting GC prognosis.
The PNI and serum levels of CEA and CA19-9 of 453 patients with GC were measured to examine correlations between those levels and patients' prognoses.
Of the 453 patients, 84 (18.5%) were positive for CEA and/or CA19-9 and therefore considered positive for TMs. Prognosis of patients who were TM+ was significantly worse than for those who were TM-. Mean PNI was 48.2 (range 27.7-63.6). ROC analysis indicated that 46.7 was the optimal PNI cutoff value. Prognosis of patients in the PNI group (<46.7) was significantly worse than in the PNI group (≥46.7). Prognosis of patients who were both TM+ and PNI was significantly worse than that of patients who were either TM+ or PNI and those who were both TM- and PNI. Multivariate analysis indicated that combination of TM and PNI was an independent prognostic indicator.
The combination of TM and PNI offers accurate information about a patient's prognosis.
血液分析物在常规临床实践中易于使用。肿瘤标志物（TMs）在胃癌（GC）的诊断、治疗和预后预测中很有用。最近还发现预后营养指数（PNI）在预测GC预后方面很有用。
测量453例GC患者的PNI以及癌胚抗原（CEA）和糖类抗原19-9（CA19-9）的血清水平，以检查这些水平与患者预后之间的相关性。
在453例患者中，84例（18.5%）CEA和/或CA19-9呈阳性，因此被认为TMs呈阳性。TMs阳性患者的预后明显比TMs阴性患者差。平均PNI为48.2（范围27.7 - 63.6）。ROC分析表明，46.7是PNI的最佳临界值。PNI组（<46.7）患者的预后明显比PNI组（≥46.7）差。TMs阳性且PNI低的患者的预后明显比TMs阳性或PNI低的患者以及TMs阴性且PNI高的患者差。多因素分析表明，TMs和PNI的联合是一个独立的预后指标。
TMs和PNI的联合提供了有关患者预后的准确信息。
