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术前预后营养指数预测 IIA 期结肠癌根治性切除术后复发风险。

Preoperative prognostic nutritional index predicts risk of recurrence after curative resection for stage IIA colon cancer.

机构信息

Department of Surgery, Mito Saiseikai General Hospital, Japan; Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Japan.

Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Japan.

出版信息

Am J Surg. 2021 Jul;222(1):179-185. doi: 10.1016/j.amjsurg.2020.10.032. Epub 2020 Oct 29.

DOI:10.1016/j.amjsurg.2020.10.032
PMID:33138968
Abstract

BACKGROUND

Preoperative nutritional and inflammatory indices have been reported to be associated with the prognosis of patients with malignancy. We evaluated clinicopathological factors, including nutritional and inflammatory indices, and recurrence prognosis in patients with stage IIA colon cancer (CC) who underwent curative surgery.

METHODS

This retrospective study included 197 patients with stage IIA CC who had undergone curative resection. We evaluated the association between prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) with clinicopathological factors and prognosis for recurrence. For the recurrence-free survival (RFS) analysis, receiver operating characteristic (ROC) curves were used to determine appropriate cutoff values for PNI, NLR, and PLR.

RESULTS

Univariate analyses showed that PNI<44.8 (P = 0.028) was significantly associated with worse RFS in patients with stage IIA CC patients. In the multivariate analyses, PNI<44.8 (hazard ratio [HR] 2.082; 95% confidence interval [CI] 1.005-4.317; P = 0.049) independently and significantly predicted RFS.

CONCLUSION

PNI is a useful marker for predicting recurrence prognosis in post-resection patients with stage IIA CC.

摘要

背景

术前营养和炎症指标与恶性肿瘤患者的预后相关。我们评估了包括营养和炎症指标在内的临床病理因素以及接受根治性手术的 IIA 期结肠癌(CC)患者的复发预后。

方法

本回顾性研究纳入了 197 例接受根治性切除术的 IIA 期 CC 患者。我们评估了预后营养指数(PNI)、中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)与临床病理因素和复发预后之间的关系。对于无复发生存率(RFS)分析,使用受试者工作特征(ROC)曲线确定 PNI、NLR 和 PLR 的适当截断值。

结果

单因素分析显示,PNI<44.8(P=0.028)与 IIA 期 CC 患者的 RFS 较差显著相关。多因素分析显示,PNI<44.8(风险比 [HR] 2.082;95%置信区间 [CI] 1.005-4.317;P=0.049)是 RFS 的独立且显著的预测因素。

结论

PNI 是预测 IIA 期 CC 患者术后复发预后的有用标志物。

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