预后营养指数在非小细胞肺癌术后放疗中的作用。
Role of prognostic nutritional index in postoperative radiotherapy for non-small cell lung cancer.
机构信息
Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea.
Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, South Korea.
出版信息
Thorac Cancer. 2023 Oct;14(28):2859-2868. doi: 10.1111/1759-7714.15074. Epub 2023 Aug 18.
BACKGROUND
The prognostic nutritional index (PNI) is known to be correlated with clinical outcomes in non-small cell lung cancer (NSCLC) patients. However, its role has not been studied in patients who have undergone postoperative radiotherapy (PORT). This study aimed to investigate the relationship between PNI and survival and recurrence in NSCLC patients with PORT.
METHODS
We reviewed 97 stage I-III NSCLC patients who received PORT between January 2006 and December 2016 at our institution. We obtained PNI values for both pre-RT (within 1 month before PORT) and post-RT (within 2 months after PORT) by using serum albumin and lymphocyte count. A cutoff value for PNI was determined by the receiver operating characteristic curve (ROC). The median follow-up period was 52.8 months.
RESULTS
The ROC curve of post-RT PNI exhibited a higher area under the curve (AUC 0.68, cut-off: 47.1) than that of pre-RT PNI (AUC 0.55, cutoff: 50.3), so the group was divided into high post-RT PNI (> 47.1) and low post-RT PNI ( 47.1). The five-year overall survival rate (OS) was 66.2% in the high post-RT group, compared with 41.8% in the low post-RT PNI group (p = 0.018). Those with both low pre-RT and low post-RT PNI had the worst five-year OS of 31.1%. Post-RT PNI (HR 0.92, p = 0.003) was an independent risk factor for mortality.
CONCLUSIONS
PNI after PORT was significantly associated with survival. This finding suggests that PNI can be used as a prognostic marker.
背景
已知预后营养指数（PNI）与非小细胞肺癌（NSCLC）患者的临床结局相关。然而，其在接受术后放疗（PORT）的患者中的作用尚未得到研究。本研究旨在探讨 PORT 后 NSCLC 患者的 PNI 与生存和复发的关系。
方法
我们回顾了 2006 年 1 月至 2016 年 12 月在我院接受 PORT 的 97 例 I-III 期 NSCLC 患者。我们通过血清白蛋白和淋巴细胞计数获得 PORT 前（PORT 前 1 个月内）和 PORT 后（PORT 后 2 个月内）的 PNI 值。通过接收者操作特征曲线（ROC）确定 PNI 的截止值。中位随访时间为 52.8 个月。
结果
PORT 后 PNI 的 ROC 曲线显示出较高的曲线下面积（AUC 0.68，截止值：47.1），高于 PORT 前 PNI 的 AUC 0.55（截止值：50.3），因此将该组分为高 PORT 后 PNI（>47.1）和低 PORT 后 PNI（ 47.1）。高 PORT 后 PNI 组的五年总生存率（OS）为 66.2%，而低 PORT 后 PNI 组为 41.8%（p=0.018）。同时存在低 PORT 前和低 PORT 后 PNI 的患者五年 OS 最差，为 31.1%。PORT 后 PNI（HR 0.92，p=0.003）是死亡的独立危险因素。
结论
PORT 后的 PNI 与生存显著相关。这一发现表明 PNI 可用作预后标志物。
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