Department of Radiation Oncology, Medicine School, Erciyes University, Kayseri, Turkey.
Eur Arch Otorhinolaryngol. 2019 Nov;276(11):3221-3230. doi: 10.1007/s00405-019-05595-2. Epub 2019 Aug 10.
We designed this retrospective study to identify predictive value of prognostic nutritional index (PNI) and albumin-globulin ratio (AGR) in nasopharyngeal cancer patients (NPC).
95 non-metastatic NPC patients were included in the study. AGR was calculated as the absolute counts between albumin and globulin measurements. (Globulin values were obtained via excluding albumin counts from total protein counts). PNI was calculated using the following formula: [10 × serum albumin value (g/dL) + 0.005 × total lymphocyte count] in the peripheral blood (per mm).
The statistically significant cutoff value of PNI was identified as 45.45 (area under the curve (AUC): 0.636, p = 0.03) for overall survival. The 5-year OS rate for patients with PNI ≤ 45.45 and PNI > 45.45 were 52.9% and 79.0%, respectively. There were statistically significant difference between groups (p = 0.03).The statistically significant cutoff value of AGR was identified as 1.19 (AUC: 0.689, p < 0.01) for overall survival. The 5-year OS rate for patients with AGR ≤ 1.19 and AGR > 1.19 were 57.7% and 82.0%. There were statistically significant differences between the groups (p = 0.04). 5-year OS rate was 42.9% in the high-risk group (low-PNI and low-AGR patients), it was 80.3% in the intermediate group (low PNI and high AGR or high PNI and low AGR) and it was 80.9% in low-risk group (high PNI and high AGR) (p = 0.004). In the multivariate analysis, age and PNI were independent prognostic factors for poorer OS (HR 2.70, 95% CI 1.091-6.719, p = 0.32 and HR 2.44, 95% CI 1.009-5.940, p = 0.48).
Low PNI is independent prognostic factor for poorer OS. Patients with low-PNI and low-AGR have worse survival than patients with high PNI and high AGR.
本回顾性研究旨在确定预后营养指数（PNI）和白蛋白-球蛋白比值（AGR）在鼻咽癌（NPC）患者中的预测价值。
本研究纳入了 95 例非转移性 NPC 患者。AGR 通过计算白蛋白和球蛋白测量值之间的绝对值得出。（球蛋白值通过从总蛋白计数中排除白蛋白计数获得）。PNI 通过以下公式计算：外周血中（每毫米）[10×血清白蛋白值（g/dL）+0.005×总淋巴细胞计数]。
PNI 的统计学显著截断值为 45.45（曲线下面积（AUC）：0.636，p=0.03），用于总生存。PNI≤45.45 和 PNI>45.45 的患者 5 年 OS 率分别为 52.9%和 79.0%，两组之间存在统计学显著差异（p=0.03）。AGR 的统计学显著截断值为 1.19（AUC：0.689，p<0.01），用于总生存。AGR≤1.19 和 AGR>1.19 的患者 5 年 OS 率分别为 57.7%和 82.0%，两组之间存在统计学差异（p=0.04）。高危组（低 PNI 和低 AGR 患者）5 年 OS 率为 42.9%，中危组（低 PNI 和高 AGR 或高 PNI 和低 AGR）为 80.3%，低危组（高 PNI 和高 AGR）为 80.9%（p=0.004）。在多变量分析中，年龄和 PNI 是较差 OS 的独立预后因素（HR 2.70，95%CI 1.091-6.719，p=0.32 和 HR 2.44，95%CI 1.009-5.940，p=0.48）。
低 PNI 是 OS 较差的独立预后因素。低 PNI 和低 AGR 的患者比高 PNI 和高 AGR 的患者生存更差。
