Wang Hao, Xu Ying-Ying, You Jun, Hu Wen-Qing, Wang Shao-Feng, Chen Ping, Yang Fan, Shi Lei, Zhao Wei, Zong Liang
Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou 225001, Jiangsu Province, China.
Department of General Surgery, Yizheng People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou 211400, Jiangsu Province, China.
World J Gastrointest Surg. 2021 Oct 27;13(10):1202-1215. doi: 10.4240/wjgs.v13.i10.1202.
Immunoinflammatory markers such as the peripheral blood neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have gained considerable attention as prognostic markers in gastrointestinal stromal tumors (GISTs).
To assess the prognostic value of Onodera's Prognostic Nutritional Index (OPNI) for GISTs.
All patients who had undergone surgical resection for a primary, localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.
A total of 235 GISTs were identified and included for analysis under our inclusion criteria. Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker, and the OPNI was associated with the primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 51.30; hazard ratio = 5.852; 95% confidence interval: 1.072-31.964; = 0.0414) was associated with worse RFS. The 2- and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%, respectively, whereas 100% and 98.41% were achieved by the patients with a high OPNI.
The preoperative OPNI is a novel and useful prognostic marker for GISTs.
免疫炎症标志物，如外周血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），作为胃肠道间质瘤（GIST）的预后标志物已受到广泛关注。
评估小野寺预后营养指数（OPNI）对GIST的预后价值。
回顾性纳入2009年至2016年在我院癌症中心接受手术切除的原发性局限性GIST患者。采用Kaplan-Meier法计算无复发生存期（RFS），并通过对数秩检验进行比较。我们使用多变量Cox比例风险回归模型来确定与结局变量的关联。
根据纳入标准，共纳入235例GIST患者进行分析。单因素和多因素分析均将OPNI确定为独立的预后标志物，且OPNI与原发部位、肿瘤大小、有丝分裂指数、肿瘤破裂、坏死及改良NIH风险分类相关。低OPNI（<51.30；风险比=5.852；95%置信区间：1.072-31.964；P=0.0414）与较差的RFS相关。低OPNI患者的2年和5年RFS率分别为92.83%和76.22%，而高OPNI患者分别为100%和98.41%。
术前OPNI是一种新型且有用的GIST预后标志物。
