Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan.
Department of Surgery, Komaki Municipal Hospital, Komaki, Japan.
Dig Surg. 2020;37(2):135-144. doi: 10.1159/000497454. Epub 2019 Mar 6.
BACKGROUND/AIMS: Identification of nutritional indicators to predict short-term and long-term outcomes is necessary to provide appropriate treatment to patients with gastric cancer.
We designed an analysis of a multicenter dataset of patients with gastric cancer who underwent gastrectomy between 2010 and 2014. We enrolled 842 eligible patients who had stage II/III gastric cancer. The area under the curve (AUC) values were compared among prognostic nutritional index (PNI), calculated as 10 × albumin g/dL + 0.005 × total lymphocyte count/mm3, and its constituents, and the predictive value of preoperative PNI for postoperative short-term and long-term outcomes was evaluated.
Preoperative PNI exhibited higher AUC values (0.719) for 1-year survival than its constituents, and the optimal cutoff value was 47. The disease-free and overall survival of patients in the PNI-low group were significantly shorter compared with those in the PNI-high group. The prognostic difference between the PNI-high and PNI-low groups was significantly greater in the subgroup of patients who underwent total gastrectomy. Clinically relevant postoperative complications were more frequently observed in the PNI-low group.
The preoperative PNI is a useful predictor reflecting the incidence of complications after gastrectomy and the prognosis of patients with stage II/III gastric cancer.
背景/目的：识别预测短期和长期预后的营养指标，对于为胃癌患者提供适当的治疗非常必要。
我们设计了一项 2010 年至 2014 年间接受胃切除术的胃癌患者多中心数据集的分析。我们纳入了 842 名符合条件的 II/III 期胃癌患者。比较了预后营养指数（PNI）、白蛋白 g/dL 与总淋巴细胞计数/mm3 的乘积的 0.005 之和（计算方法为 10×白蛋白 g/dL+0.005×总淋巴细胞计数/mm3）及其组成部分的曲线下面积（AUC）值，并评估了术前 PNI 对术后短期和长期预后的预测价值。
术前 PNI 对 1 年生存率的 AUC 值（0.719）高于其组成部分，最佳截断值为 47。PNI 低组患者的无病生存率和总生存率明显短于 PNI 高组。在接受全胃切除术的患者亚组中，PNI 高低组之间的预后差异更为显著。PNI 低组患者更常出现临床相关的术后并发症。
术前 PNI 是一种有用的预测指标，反映了胃癌患者接受胃切除术后并发症的发生情况和预后。
