Huang Yang-Yu, Liang Shen-Hua, Hu Yu, Liu Xuan, Ma Guo-Wei
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
Front Nutr. 2022 Jul 8;9:868336. doi: 10.3389/fnut.2022.868336. eCollection 2022.
Systemic nutrition and immune inflammation are the key factors in cancer development and metastasis. This study aimed to compare and assess four nutritional status and immune indicators: prognostic nutritional index (PNI), nutritional risk index (NRI), neutrophil-to-lymphocyte ratio (NLR), and the systemic immune-inflammatory index (SII) as prognostic indicators for patients with thymic epithelial tumors.
We retrospectively reviewed 154 patients who underwent thymic epithelial tumor resection at our hospital between 2004 and 2015. The optimal cutoff value for each nutritional and immune index was obtained using the X-tile software. Kaplan-Meier curves and Cox proportional hazards models were used for survival analysis.
Univariate analysis showed that PNI, NRI, NLR, SII, albumin (ALB), the albumin/globulin ratio (A/G), WHO stage, T stage, and drinking history were associated with the overall survival (OS) of patients ( < 0.05). The NRI, NLR, A/G, ALB, T stage, and WHO stage were significant independent prognostic factors of OS in multivariate analysis ( < 0.05). Finally, we constructed a coNRI-NLR model to predict OS and recurrence-free survival (RFS).
This study suggests that the preoperative NRI, NLR, and coNRI-NLR model may be important prognostic factors for patients with thymic epithelial tumors who undergo surgical resection.
全身营养和免疫炎症是癌症发生和转移的关键因素。本研究旨在比较和评估四种营养状况和免疫指标：预后营养指数（PNI）、营养风险指数（NRI）、中性粒细胞与淋巴细胞比值（NLR）以及全身免疫炎症指数（SII），作为胸腺上皮肿瘤患者的预后指标。
我们回顾性分析了2004年至2015年间在我院接受胸腺上皮肿瘤切除术的154例患者。使用X-tile软件获得每个营养和免疫指标的最佳临界值。采用Kaplan-Meier曲线和Cox比例风险模型进行生存分析。
单因素分析显示，PNI、NRI、NLR、SII、白蛋白（ALB）、白蛋白/球蛋白比值（A/G）、世界卫生组织（WHO）分期、T分期和饮酒史与患者的总生存期（OS）相关（<0.05）。多因素分析中，NRI、NLR、A/G、ALB、T分期和WHO分期是OS的显著独立预后因素（<0.05）。最后，我们构建了一个联合NRI-NLR模型来预测OS和无复发生存期（RFS）。
本研究表明，术前NRI、NLR和联合NRI-NLR模型可能是接受手术切除的胸腺上皮肿瘤患者的重要预后因素。
