Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, 4-66 Syounen-cho Nakagawa-ku, Nagoya, 454-8502, Japan.
BMC Oral Health. 2021 Jan 22;21(1):40. doi: 10.1186/s12903-021-01394-6.
The systemic inflammatory response and nutritional status of patients with malignant tumors are related to postoperative results. We examined the usefulness of the prognostic nutritional index (PNI) as a prognostic tool in patients with oral squamous cell carcinoma who underwent radical surgery.
From 2008 to 2019, 102 patients (73 males, 29 females; age, 65.6 ± 9.8 years) who visited our hospital and underwent surgical therapy were included in this study. The endpoint was the total survival period, and the evaluation markers included the lymphocyte count and albumin level in peripheral blood obtained 4 weeks preoperatively, age, sex, alcohol consumption, smoking history, site of the tumor, pathological stage, and surgery status. The PNI was calculated using serum albumin levels and the peripheral blood lymphocyte count. The relationship between the PNI and patient characteristics were analyzed using Fisher's exact test. The Kaplan-Meier method was used to evaluate the survival rate. The survival periods were compared using the log-rank method. We evaluated the prognostic factors for overall survival (OS) and disease-free survival (DFS) in a logistic regression model.
The tumor sites included the maxilla (n = 12), buccal mucosa (n = 11), mandible (n = 17), floor of the mouth (n = 9), and tongue (n = 53). The number of patients with stage I, II, III, and IV oral cancers was 28 (27.5%), 34 (27.5%), 26 (33.3%), and 14 (13.7%), respectively. During the observation period, 21 patients died of head and neck cancer. The optimal cut-off PNI value was 42.9, according to the receiver operating characteristic analysis. The proportion of patients with a short OS was lower in those with PNI higher than 42.9, and the 5-year OS in patients with PNI higher and lower than the cut-off value was 62.3% and 86.0%, respectively (P = 0.0105).
The OS of patients with PNI < 42.9 was lower than that of patients with PNI ≥ 42.9. The PNI, which is a preoperative head-to-foot inflammatory marker, can help in estimating the prognosis of oral cancer.
恶性肿瘤患者的全身炎症反应和营养状况与术后结果有关。我们研究了预后营养指数（PNI）作为评估接受根治性手术的口腔鳞状细胞癌患者预后的工具的有效性。
本研究纳入了 2008 年至 2019 年间在我院就诊并接受手术治疗的 102 例患者（73 例男性，29 例女性；年龄 65.6±9.8 岁）。终点是总生存时间，评估标志物包括术前 4 周外周血中的淋巴细胞计数和白蛋白水平、年龄、性别、饮酒史、吸烟史、肿瘤部位、病理分期和手术情况。PNI 是通过血清白蛋白水平和外周血淋巴细胞计数计算得出的。采用 Fisher 确切检验分析 PNI 与患者特征之间的关系。采用 Kaplan-Meier 法评估生存率。采用对数秩检验比较生存时间。我们在 logistic 回归模型中评估了总生存（OS）和无病生存（DFS）的预后因素。
肿瘤部位包括上颌（n=12）、颊黏膜（n=11）、下颌（n=17）、口底（n=9）和舌（n=53）。I 期、II 期、III 期和 IV 期口腔癌患者分别为 28 例（27.5%）、34 例（27.5%）、26 例（33.3%）和 14 例（13.7%）。在观察期间，有 21 例患者死于头颈部癌症。根据受试者工作特征分析，最佳截断 PNI 值为 42.9。OS 较短的患者 PNI 高于 42.9 的比例较低，PNI 高于和低于截断值的患者 5 年 OS 分别为 62.3%和 86.0%（P=0.0105）。
PNI<42.9 的患者 OS 低于 PNI≥42.9 的患者。PNI 是一种术前从头到脚的炎症标志物，有助于估计口腔癌的预后。
