Department of Health and Medical Informatics, Kyungnam University College of Health Sciences, Changwon, Republic of Korea.
Department of Urology, Ajou University School of Medicine, Suwon, Korea.
PLoS One. 2022 Aug 5;17(8):e0271821. doi: 10.1371/journal.pone.0271821. eCollection 2022.
Prognostic nutritional index (PNI) is a simple parameter which reflects patient's nutritional and inflammatory status and reported as a prognostic factor for renal cell carcinoma (RCC). Studies were included from database inception until February 2, 2022. The aim of this study is to evaluate prognostic value of PNI by meta-analysis of the diagnostic test accuracy in RCC.
Studies were retrieved from PubMed, Cochrane, and EMBASE databases and assessed sensitivity, specificity, summary receiver operating characteristic curve (SROC) and area under curve (AUC). Totally, we identified 11 studies with a total of 7,296 patients were included to evaluate the prognostic value of PNI in RCC finally. They indicated a pooled sensitivity of 0.733 (95% CI, 0.651-0.802), specificity of 0.615 (95% CI, 0.528-0.695), diagnostic odds ratio (DOR) of 4.382 (95% CI, 3.148-6.101) and AUC of 0.72 (95% CI, 0.68-0.76). Heterogeneity was significant and univariate meta-regression revealed that metastasis and cut-off value of PNI might be the potential source of heterogeneity. Multivariate meta-regression analysis also demonstrated that metastasis might be the source of heterogeneity.
PNI demonstrated a good diagnostic accuracy as a prognostic factor for RCC and especially in case of metastatic RCC.
预后营养指数（PNI）是一个简单的参数，反映了患者的营养和炎症状态，被报道为肾细胞癌（RCC）的预后因素。本研究的目的是通过对 RCC 的诊断测试准确性进行荟萃分析，评估 PNI 的预后价值。
从 PubMed、Cochrane 和 EMBASE 数据库中检索到研究，并评估了敏感性、特异性、汇总受试者工作特征曲线（SROC）和曲线下面积（AUC）。最终，我们确定了 11 项研究，共纳入 7296 例患者，用于评估 PNI 在 RCC 中的预后价值。结果表明，PNI 的合并敏感性为 0.733（95%置信区间，0.651-0.802），特异性为 0.615（95%置信区间，0.528-0.695），诊断比值比（DOR）为 4.382（95%置信区间，3.148-6.101），AUC 为 0.72（95%置信区间，0.68-0.76）。异质性显著，单变量meta 回归显示转移和 PNI 的截断值可能是异质性的潜在来源。多变量meta 回归分析也表明转移可能是异质性的来源。
PNI 作为 RCC 的预后因素具有良好的诊断准确性，尤其是在转移性 RCC 中。
