Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan.
Department of Radiology, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan.
Oral Dis. 2022 Oct;28(7):1816-1830. doi: 10.1111/odi.13840. Epub 2021 Apr 23.
To investigate whether prognostic nutritional index (PNI) predicts patient survival outcomes in oral cavity squamous cell carcinoma (OSCC).
The data of a total of 360 patients subjected to primary surgery for OSCC were retrospectively analysed. Patients were categorised into high-PNI (≥51.75) and low-PNI (<51.75) groups based on the PNI cut-off value attained from receiver operating characteristic analyses (p < .001), and the intergroup differences in clinicopathological features were determined. The Kaplan-Meier method and Cox proportional hazard model were employed to determine the survival prediction ability of the PNI, and a nomogram based on the PNI was established for individualised survival prediction.
A low PNI was noted to exhibit a significant association with shorter overall survival (OS) and disease-free survival (DFS) (both p < .001). Multivariate Cox analyses showed that a lower PNI independently indicated shorter OS and DFS (hazard ratio [HR] = 2.187; p = .001 and HR = 1.459; p = .023, respectively). The concordance index and calibration plots of the PNI-based nomogram revealed the high discriminative ability for OS.
Preoperative PNI is a valuable biomarker for predicting OSCC prognosis, and the proposed PNI-based nomogram can provide individualised prognostic prediction.
探讨预后营养指数（PNI）是否能预测口腔鳞状细胞癌（OSCC）患者的生存结局。
回顾性分析了 360 例接受 OSCC 根治性手术的患者资料。根据接受者操作特征分析（p <.001）得出的 PNI 截断值，将患者分为高 PNI（≥51.75）和低 PNI（<51.75）组，确定组间临床病理特征的差异。采用 Kaplan-Meier 法和 Cox 比例风险模型确定 PNI 的生存预测能力，并建立基于 PNI 的列线图进行个体化生存预测。
低 PNI 与较短的总生存期（OS）和无病生存期（DFS）显著相关（均 p <.001）。多因素 Cox 分析表明，较低的 PNI 独立预示着较短的 OS 和 DFS（风险比 [HR] = 2.187；p =.001 和 HR = 1.459；p =.023）。基于 PNI 的列线图的一致性指数和校准图显示了其对 OS 具有较高的判别能力。
术前 PNI 是预测 OSCC 预后的有价值的生物标志物，所提出的基于 PNI 的列线图可提供个体化的预后预测。
