Division of Hospital Dentistry, Central Clinical Department, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Esophagus. 2021 Jan;18(1):49-55. doi: 10.1007/s10388-020-00751-8. Epub 2020 Jun 7.
The Prognostic Nutritional Index is useful for predicting surgical risk and overall survival based on preoperative immunological and nutritional status in patients undergoing digestive organ cancer surgery. The purpose of this study was to examine the association between the Prognostic Nutritional Index and dental status in patients with esophageal cancer who underwent esophagectomy.
This retrospective case-control study included 73 patients who underwent resection of esophageal cancer (69 males, 4 females; age 36-83). General and dental status were evaluated. The Prognostic Nutritional Index was calculated based on the serum albumin concentration and the total lymphocyte count, and subjects were divided into two groups based on index scores: a higher group, characterized by scores ≥ 45 (n = 54); and a lower group, characterized by scores < 45 (n = 19). Univariate analysis and multiple logistic regression analyses were used to compare between groups.
Total protein, C-reactive protein, the number of sound and total decayed, missing and filled teeth, and the rate of patients with poor dental occlusal support showed significant differences between the lower and higher Prognostic Nutritional Index groups (p < 0.05). Stepwise logistic regression analysis by backward selection approach showed that low total protein, few sound teeth, and poor status of dental occlusal support were significantly associated with the lower Prognostic Nutritional Index (p = 0.007, 0.042, and 0.009, respectively).
Dental status, especially dental occlusal support and the number of sound teeth, showed a positive relationship with the Prognostic Nutritional Index in esophageal cancer patients who underwent esophagectomy.
预后营养指数可根据接受消化道癌症手术患者的术前免疫和营养状态，用于预测手术风险和总体生存率。本研究旨在探讨预后营养指数与接受食管癌切除术患者的口腔状况之间的关系。
本回顾性病例对照研究纳入了 73 例接受食管癌切除术的患者（男性 69 例，女性 4 例；年龄 36-83 岁）。评估了一般和口腔状况。根据血清白蛋白浓度和总淋巴细胞计数计算预后营养指数，并根据指数评分将患者分为两组：高分组，评分≥45（n=54）；低分组，评分<45（n=19）。采用单因素分析和多因素逻辑回归分析比较组间差异。
总蛋白、C 反应蛋白、完好牙和总龋齿、缺失和填补牙的数量以及口腔咬合支持不良的患者比例在低和高分组之间存在显著差异（p<0.05）。逐步向后选择法的逻辑回归分析显示，低总蛋白、牙齿完好数少和口腔咬合支持不良与低预后营养指数显著相关（p=0.007、0.042 和 0.009）。
在接受食管癌切除术的患者中，口腔状况，尤其是口腔咬合支持和完好牙的数量与预后营养指数呈正相关。
