Maejima Kentaro, Taniai Nobuhiko, Yoshida Hiroshi
Department of Surgery, Hasuda Hospital.
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Musashikosugi Hospital.
J Nippon Med Sch. 2022 Nov 9;89(5):487-493. doi: 10.1272/jnms.JNMS.2022_89-507. Epub 2022 May 30.
Gastric cancer can recur soon after treatment. We evaluated the prognostic nutritional index (PNI), a predictor of postoperative complications, and examined the association of PNI with progression and recurrence of gastric cancer.
We retrospectively investigated data from 697 patients who had undergone surgery for gastric carcinoma (excluding those with stage IV disease) and analyzed associations of age, sex, performance status (PS), American Society of Anesthesiologists (ASA) classification, diabetes, depth of main tumor (T), lymph node metastasis, postoperative complications, recurrence, and survival with PNI. We also performed multivariate analysis to identify factors associated with survival.
PNI significantly decreased with age and was significantly lower in women. PNI was significantly positively correlated with PS. PNI was significantly lower for ≥T2 cancers and in patients with lymph node metastasis. There was no association between postoperative complications and PNI. PNI was significantly lower for patients who developed recurrence than for those who did not. The survival rate was examined for groups with a PNI of ≥45 (high PNI) and <45 (low PNI). Both 5-year overall survival (OS) and cancer-specific survival (CS) were significantly worse for the low PNI group. Multivariate analysis showed that PNI was an independent predictor of OS and CS.
PNI was associated with progression and recurrence of gastric cancer.
胃癌在治疗后可能很快复发。我们评估了作为术后并发症预测指标的预后营养指数（PNI），并研究了PNI与胃癌进展和复发的关联。
我们回顾性调查了697例接受胃癌手术患者（不包括IV期疾病患者）的数据，分析了年龄、性别、体能状态（PS）、美国麻醉医师协会（ASA）分级、糖尿病、主要肿瘤深度（T）、淋巴结转移、术后并发症、复发以及生存与PNI的关联。我们还进行了多变量分析以确定与生存相关的因素。
PNI随年龄显著降低，且在女性中显著更低。PNI与PS显著正相关。对于≥T2期癌症患者和有淋巴结转移的患者，PNI显著更低。术后并发症与PNI之间无关联。发生复发的患者的PNI显著低于未复发患者。对PNI≥45（高PNI）和<45（低PNI）的组进行了生存率检查。低PNI组的5年总生存（OS）率和癌症特异性生存（CS）率均显著更差。多变量分析显示PNI是OS和CS的独立预测指标。
PNI与胃癌的进展和复发相关。
