Lv Xiaoyan, Zhang Zongxin, Yuan Wenbin
Operating Room, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China.
Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China.
Nutr Cancer. 2021;73(10):1872-1881. doi: 10.1080/01635581.2020.1817955. Epub 2020 Sep 15.
Many reports have shown that the prognostic nutritional index (PNI) is associated with the clinical outcomes of patients with biliary tract cancer (BTC), with the results being inconsistent. We therefore comprehensively evaluated the prognostic significance of the PNI in BTC by performing a meta-analysis.
We identified relevant studies by searching PubMed, Embase, Web of Science and, the Cochrane Library. The combined hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI) were used to evaluate the association between PNI and overall survival (OS) and the clinical characteristics of BTC.
We included seven studies with 1608 patients in this meta-analysis. The pretreatment low PNI correlated significantly with worse OS (HR = 1.65, 95%CI = 1.42-1.93, < 0.001). In addition, the prognostic effect of PNI are reliable in different subgroups of ethnicity, sample size, histology, treatment, PNI cutoff, and cutoff determination. The low PNI was also related to poor differentiation (OR = 1.95, 95%CI = 1.34-2.85, = 0.001) as well as higher T stage (OR = 2.51, 95%CI = 1.69-3.74, < 0.001) in BTC.
The low PNI is significantly associated with inferior prognosis of patients with BTC and aggressive clinical factors. The PNI could be applied as an independent prognostic marker for patients with BTC.
许多报告显示，预后营养指数（PNI）与胆道癌（BTC）患者的临床结局相关，但结果并不一致。因此，我们通过进行荟萃分析全面评估了PNI在BTC中的预后意义。
我们通过检索PubMed、Embase、Web of Science和Cochrane图书馆来识别相关研究。采用合并风险比（HR）和比值比（OR）及95%置信区间（CI）来评估PNI与总生存期（OS）以及BTC临床特征之间的关联。
本荟萃分析纳入了7项研究，共1608例患者。治疗前低PNI与较差的OS显著相关（HR = 1.65，95%CI = 1.42 - 1.93，P < 0.001）。此外，PNI在种族、样本量、组织学、治疗、PNI临界值和临界值确定的不同亚组中的预后效应是可靠的。低PNI还与BTC的低分化（OR = 1.95，95%CI = 1.34 - 2.85，P = 0.001）以及更高的T分期（OR = 2.51，95%CI = 1.69 - 3.74，P < 0.001）相关。
低PNI与BTC患者的不良预后及侵袭性临床因素显著相关。PNI可作为BTC患者独立的预后标志物。
