Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Cell Physiol. 2019 Aug;234(10):18408-18414. doi: 10.1002/jcp.28476. Epub 2019 Mar 19.
The aim of this study was to evaluate the relationship between prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) and clinical features and prognosis of osteosarcoma patients. We retrospectively investigated 126 patients with surgery for osteosarcoma between 2012 and 2018 at our hospital. The preoperative PNI was calculated as albumin level (g/L) + 5 × total lymphocyte count (10 /L). The SII was defined as platelet × neutrophil/lymphocyte counts. The optimal cut-off values for PNI and SII were evaluated with receiver operating curve analysis. Clinical features and PNI and SII were tested with the χ test. The effects of PNI and SII on overall survival (OS) was investigated by Kaplan-Meier method and Cox proportional hazards model. A low preoperative PNI was remarkably correlated with tumor size, Enneking stage, pathological fracture, local recurrence, metastasis, and neoadjuvant chemotherapy ( p < 0.05). Whereas, a high SII was significantly associated with tumor size, histological type, Enneking stage, and neoadjuvant chemotherapy ( p < 0.05). There was a significant negative relationship between the PNI and SII ( r = 0.384; p < 0.001). For univariate analyses, the results revealed that tumor size, local recurrence, metastasis, PNI, and SII were predictors of OS ( p < 0.05). In multivariate analyses, local recurrence ( p = 0.010), metastasis ( p < 0.001), PNI ( p < 0.001), and SII ( p = 0.029) as independent prognostic factors were significantly correlated with OS. This study suggested that PNI and SII could be important prognostic parameters for patients with osteosarcoma.
本研究旨在评估预后营养指数（PNI）和全身免疫炎症指数（SII）与骨肉瘤患者临床特征和预后的关系。我们回顾性调查了 2012 年至 2018 年在我院接受手术治疗的 126 例骨肉瘤患者。术前 PNI 计算为白蛋白水平（g/L）+5×总淋巴细胞计数（10 /L）。SII 定义为血小板×中性粒细胞/淋巴细胞计数。使用受试者工作特征曲线分析评估 PNI 和 SII 的最佳截断值。使用 χ 检验检测临床特征和 PNI 和 SII。Kaplan-Meier 法和 Cox 比例风险模型分析 PNI 和 SII 对总生存（OS）的影响。低术前 PNI 与肿瘤大小、Enneking 分期、病理骨折、局部复发、转移和新辅助化疗显著相关（p < 0.05）。而高 SII 与肿瘤大小、组织学类型、Enneking 分期和新辅助化疗显著相关（p < 0.05）。PNI 和 SII 之间存在显著负相关（r = 0.384；p < 0.001）。单因素分析结果表明，肿瘤大小、局部复发、转移、PNI 和 SII 是 OS 的预测因素（p < 0.05）。多因素分析结果表明，局部复发（p = 0.010）、转移（p < 0.001）、PNI（p < 0.001）和 SII（p = 0.029）是 OS 的独立预后因素。本研究表明，PNI 和 SII 可能是骨肉瘤患者的重要预后参数。
