Zheng Zhiwei, Zhu Huide, Cai Hongfu
Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, China.
Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.
Front Nutr. 2022 Apr 13;9:824839. doi: 10.3389/fnut.2022.824839. eCollection 2022.
Prognostic nutritional index (PNI) is one of the most important factors related to prognosis in many types of cancer. This study aimed to evaluate the PNI on predicting the overall survival (OS) in resectable esophageal squamous cell carcinoma (ESCC).
A total of 165 patients with resectable ESCC were included in our retrospective study. PNI values before surgery were calculated for each patient [PNI = 10 × albumin (gr/dL) + 0.005 × total lymphocyte count (mm)]. PNI cutoff value was selected by drawing receiver operating characteristics (ROC) curve, which used OS time as the endpoint. The Kaplan-Meier method and the Cox regression model of multivariate analysis were used to analyze the prognostic relationship between PNI and OS.
Among the 165 patients, 34 (20.6%) were women and 131 (79.4%) were men. The mean age was 62.67 ± 7.95 years, with the age range from 44 to 85 years. The average PNI was 46.68 ± 8.66. ROC curve showed that the best cutoff value was 43.85. All patients were divided into two groups: 72 patients (43.6%) were in the low PNI group (<43.85), while 93 patients (56.4%) were in the high PNI group (≥ 43.85). Univariate analysis demonstrated that PNI, tumor length, and T-stage and pathological stage were related to the prognosis of patients with ESCC ( <0.05). The Kaplan-Meier curve showed that the high PNI group has significantly increased OS compared to low PNI group ( = 0.01). Three-year OS rates were 57.5% in the low PNI group while 77.7% in the high PNI group. Univariate analysis showed that advanced pathological stage, large tumor length, and low PNI (separately, < 0.05) were significant risk factors for shorter OS. Multivariate analysis showed that tumor length ( = 0.008) and PNI ( = 0.017) were independent prognostic factors in patients with resectable ESCC.
PNI is a simple and useful predictive marker for the OS time in patients with radical esophagectomy.
预后营养指数（PNI）是多种癌症中与预后相关的最重要因素之一。本研究旨在评估PNI对可切除食管鳞状细胞癌（ESCC）总生存期（OS）的预测价值。
本回顾性研究共纳入165例可切除ESCC患者。计算每位患者术前的PNI值[PNI = 10×白蛋白（g/dL）+ 0.005×总淋巴细胞计数（/mm）]。通过绘制以OS时间为终点的受试者工作特征（ROC）曲线来选择PNI临界值。采用Kaplan-Meier法和多变量分析的Cox回归模型分析PNI与OS之间的预后关系。
165例患者中，女性34例（20.6%），男性131例（79.4%）。平均年龄为62.67±7.95岁，年龄范围为44至85岁。平均PNI为46.68±8.66。ROC曲线显示最佳临界值为43.85。所有患者分为两组：72例患者（43.6%）为低PNI组（<43.85），93例患者（56.4%）为高PNI组（≥43.85）。单变量分析表明，PNI、肿瘤长度、T分期和病理分期与ESCC患者的预后相关（<0.05）。Kaplan-Meier曲线显示，高PNI组的OS较之于低PNI组显著延长（=0.01）。低PNI组的三年OS率为57.5%，而高PNI组为77.7%。单变量分析显示，晚期病理分期、肿瘤长度大以及PNI低（分别为，<0.05）是OS缩短的显著危险因素。多变量分析显示，肿瘤长度（=0.008）和PNI（=0.017）是可切除ESCC患者的独立预后因素。
PNI是根治性食管切除患者OS时间的一个简单且有用的预测指标。
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