a Department of General Surgery , The Third Hospital of Mianyang the Mental Health Center of Sichuan , Mianyang , Sichuan , China.
Nutr Cancer. 2019;71(4):557-568. doi: 10.1080/01635581.2019.1577986. Epub 2019 Feb 22.
The primary aim of this systematic review was to evaluate the survival predication value of preoperative prognostic nutritional index (PNI) in patients with gastric cancer. The second aim was to explore the relationship between preoperative PNI and clinicopathological features.
A systematic search of the electronic databases identified studies that investigated the association of preoperative PNI with short or long-term outcomes among patients after gastrectomy for cancer. Qualitative and quantitative analysis of results was conducted.
Twenty-five studies with a total of 14,403 patients with gastric cancer met inclusion criteria for this review. Pooled analysis demonstrated that low preoperative PNI was associated with significantly reduced overall survival (HR 1.81, 95% CI: 1.56-2.09; P = 0.000), cancer-specific survival (HR 1.61, 95% CI: 1.24-2.10; P = 0.000), and recurrence-free survival (HR 1.82, 95% CI: 1.20-2.77; P = 0.005). In addition, risk of postoperative complications (POCs) and mortality was significantly higher in patients with lower preoperative PNI (RR 1.77, 95% CI: 1.44-2.17; P = 0.000 and RR 5.14, 95% CI: 2.23-11.79; P = 0.000, respectively).
This study suggests that patients with low preoperative PNI may have a high incidence of POCs and poor prognosis following gastrectomy for cancer.
本系统评价的主要目的是评估术前预后营养指数（PNI）对胃癌患者生存预测的价值。第二个目的是探讨术前 PNI 与临床病理特征的关系。
系统检索电子数据库，以确定研究术前 PNI 与接受胃癌根治性切除术患者短期或长期结局之间关系的研究。对结果进行定性和定量分析。
共有 25 项研究纳入了 14403 例接受胃癌根治性切除术的患者，符合本综述的纳入标准。汇总分析表明，术前 PNI 较低与总生存（HR 1.81，95%CI：1.56-2.09；P=0.000）、癌症特异性生存（HR 1.61，95%CI：1.24-2.10；P=0.000）和无复发生存（HR 1.82，95%CI：1.20-2.77；P=0.005）显著降低相关。此外，术前 PNI 较低的患者术后并发症（POCs）和死亡率的风险显著增加（RR 1.77，95%CI：1.44-2.17；P=0.000 和 RR 5.14，95%CI：2.23-11.79；P=0.000）。
本研究表明，术前 PNI 较低的患者在接受胃癌根治性切除术治疗后可能会发生较高的 POCs 且预后较差。
