Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong-an Road, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
BMC Cancer. 2018 Sep 10;18(1):883. doi: 10.1186/s12885-018-4732-8.
The aim of our study was to investigate whether an inflammation-based prognostic score, the prognostic nutritional index (PNI), was associated with clinical characteristics and prognosis in patients with high-grade serous ovarian cancer (HGSC).
We retrospectively investigated 875 patients who underwent primary staging or debulking surgery for HGSC between April 2005 and June 2013 at our institution. None of these patients received neoadjuvant chemotherapy. Preoperative PNI was calculated as serum albumin (g/L) + 0.005 × lymphocyte count (per mm). The optimal PNI cutoff value for overall survival (OS) was identified using the online tool "Cutoff Finder". Clinical characteristics and PNI were compared with chi-square or Fisher's exact tests, as appropriate. The impact of PNI on OS was analyzed using the Kaplan-Meier method and Cox proportional hazards model.
The median (range) PNI was 46.2 (29.2-67.7). The 45.45 cutoff value discriminated patients into the high-PNI and low-PNI groups. A low preoperative PNI was associated with an advanced FIGO stage, increased CA125 level, more extensive ascites, residual disease and platinum resistance. For univariate analyses, a high PNI was associated with increased OS (p < 0.001). In multivariate analyses, the PNI remained an independent predictor of OS as a continuous variable (p = 0.021) but not as dichotomized groups (p = 0.346).
Our study demonstrated that the PNI could be a predictive and prognostic parameter for HGSC.
本研究旨在探讨炎症相关预后评分——预后营养指数（PNI）与高级别浆液性卵巢癌（HGSC）患者临床特征和预后的关系。
我们回顾性分析了 2005 年 4 月至 2013 年 6 月在我院接受 HGSC 初次分期或肿瘤细胞减灭术的 875 例患者。所有患者均未接受新辅助化疗。术前 PNI 采用血清白蛋白（g/L）+0.005×淋巴细胞计数（每毫米）计算。使用在线工具“Cutoff Finder”确定总生存期（OS）的最佳 PNI 截断值。采用卡方检验或 Fisher 确切概率法比较临床特征和 PNI。采用 Kaplan-Meier 法和 Cox 比例风险模型分析 PNI 对 OS 的影响。
PNI 的中位数（范围）为 46.2（29.2-67.7）。45.45 截断值将患者分为高 PNI 组和低 PNI 组。术前低 PNI 与 FIGO 分期较晚、CA125 水平升高、腹水较多、残留病灶和铂类耐药相关。单因素分析显示，高 PNI 与 OS 延长相关（p<0.001）。多因素分析显示，PNI 作为连续变量与 OS 相关（p=0.021），但作为二分类变量与 OS 不相关（p=0.346）。
本研究表明，PNI 可能是 HGSC 的预测和预后指标。
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