Jeong Ho, Kim Kil Hwan, Jo Sungho, Song Sanghyun
Department of Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
Ann Hepatobiliary Pancreat Surg. 2021 Nov 30;25(4):456-461. doi: 10.14701/ahbps.2021.25.4.456.
BACKGROUNDS/AIMS: The purpose of this retrospective study was to determine the association between prognostic nutritional index (PNI) and recurrence of hepatocellular carcinoma after a curative resection.
Between 2007 to 2019, 130 patients who underwent curative hepatectomy for hepatocellular carcinoma were enrolled. PNI was calculated. Its cutoff value was identified through receiver operating characteristic curve analysis. According to PNI, patients were divided into two groups. Univariate and multivariate analyses were performed to identify independent risk factors for recurrence.
The cutoff value of PNI was 52. In univariate analysis, alcoholic liver cirrhosis ( = 0.041), protein induced by vitamin K antagonist- II ≥ 200 ( = 0.012), indocyanine green retention test (ICG R15) >10% ( = 0.001), estimated blood loss ≥ 800 mL ( = 0.037), tumor size ( = 0.001), microvascular invasion ( = 0.023), T-stage ( = 0.001), and PNI < 52 ( = 0.001) were significant factors affecting the recurrence. In multivariate analysis, alcoholic liver cirrhosis ( = 0.046), ICG R15 >10% ( = 0.025), T-stage ( = 0.003), and PNI < 52 ( = 0.046) were independent prognostic factors for disease-free survival.
PNI, a nutritional and immunologic factor, is an independent prognostic factor that can predict the recurrence of hepatocellular carcinoma in patients undergoing a curative resection.
背景/目的：本回顾性研究的目的是确定预后营养指数（PNI）与肝细胞癌根治性切除术后复发之间的关联。
纳入2007年至2019年间130例行肝细胞癌根治性肝切除术的患者。计算PNI。通过受试者工作特征曲线分析确定其临界值。根据PNI将患者分为两组。进行单因素和多因素分析以确定复发的独立危险因素。
PNI的临界值为52。单因素分析中，酒精性肝硬化（P = 0.041）、维生素K拮抗剂诱导蛋白II≥200（P = 0.012）、吲哚菁绿滞留率（ICG R15）>10%（P = 0.001）、估计失血量≥800 mL（P = 0.037）、肿瘤大小（P = 0.001）、微血管侵犯（P = 0.023）、T分期（P = 0.001）及PNI<52（P = 0.001）是影响复发的显著因素。多因素分析中，酒精性肝硬化（P = 0.046）、ICG R15>10%（P = 0.025）、T分期（P = 0.003）及PNI<52（P = 0.046）是无病生存的独立预后因素。
PNI作为一种营养和免疫因素，是可预测肝细胞癌根治性切除术后患者复发的独立预后因素。
