Hung Kuo-Chuan, Sun Cheuk-Kwan, Chang Yang-Pei, Wu Jheng-Yan, Huang Po-Yu, Liu Ting-Hui, Lin Chien-Hung, Cheng Wan-Jung, Chen I-Wen
School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.
Front Oncol. 2023 Jul 24;13:1188292. doi: 10.3389/fonc.2023.1188292. eCollection 2023.
The potential link between Prognostic Nutritional Index (PNI) and prognosis in patients with glioma remains uncertain. This meta-analysis was conducted to assess the clinical value of PNI in glioma patients by integrating all available evidence to enhance statistical power.
A systematic search of databases including Medline, EMBASE, Google Scholar, and Cochrane Library was conducted from inception to January 8, 2023 to retrieve all pertinent peer-reviewed articles. The primary outcome of the study was to examine the association between a high PNI value and overall survival, while secondary outcome included the relationship between a high PNI and progression-free survival.
In this meta-analysis, we included 13 retrospective studies published from 2016 to 2022, which analyzed a total of 2,712 patients. Across all studies, surgery was the primary treatment modality, with or without chemotherapy and radiotherapy as adjunct therapies. A high PNI was linked to improved overall survival (Hazard Ratio (HR) = 0.61, 95% CI: 0.52 to 0.72, < 0.00001, I25%), and this finding remained consistent even after conducting sensitivity analysis. Subgroup analyses based on ethnicity (Asian vs. non-Asian), sample size (<200 vs. >200), and source of hazard ratio (univariate vs. multivariate) yielded consistent outcomes. Furthermore, patients with a high PNI had better progression-free survival than those with a low PNI (HR=0.71, 95% CI: 0.58 to 0.88, =0.001, I0%).
Our meta-analysis suggested that a high PNI was associated with better overall survival and progression-free survival in patients with glioma. These findings may have important implications in the treatment of patients with glioma. Additional studies on a larger scale are necessary to investigate if integrating the index into the treatment protocol leads to improved clinical outcomes in individuals with glioma.
[https://www.crd.york.ac.uk/prospero/], identifier [CRD42023389951].
预后营养指数（PNI）与胶质瘤患者预后之间的潜在联系仍不明确。本荟萃分析旨在通过整合所有可用证据以增强统计效力，评估PNI在胶质瘤患者中的临床价值。
从数据库建立至2023年1月8日，对包括Medline、EMBASE、谷歌学术和Cochrane图书馆在内的数据库进行系统检索，以获取所有相关的同行评审文章。该研究的主要结局是检验高PNI值与总生存期之间的关联，次要结局包括高PNI与无进展生存期之间的关系。
在本荟萃分析中，我们纳入了2016年至2022年发表的13项回顾性研究，共分析了2712例患者。在所有研究中，手术是主要治疗方式，辅助治疗包括化疗和放疗，或不包括。高PNI与总生存期改善相关（风险比（HR）=0.61，95%可信区间：0.52至0.72，P<0.00001，I²=5%），即使在进行敏感性分析后，这一发现仍然一致。基于种族（亚洲人与非亚洲人）、样本量（<200与>200）以及风险比来源（单变量与多变量）的亚组分析得出了一致的结果。此外，高PNI患者的无进展生存期优于低PNI患者（HR=0.71，95%可信区间：0.58至0.88，P=0.001，I²=0%）。
我们的荟萃分析表明，高PNI与胶质瘤患者更好的总生存期和无进展生存期相关。这些发现可能对胶质瘤患者的治疗具有重要意义。有必要进行更大规模的进一步研究，以调查将该指数纳入治疗方案是否能改善胶质瘤患者的临床结局。
