Zhang Li, Wang Fengliang, Wan Cong, Tang Jichun, Qin Jiarui
Department of Gynaecology and obstetrics, Beijing Integrated Traditional Chinese and Western Medicine Hospital, Beijing, 100038, China.
Department of Obstetrics and Gynecology, China Aerospace Science and Industry Group 731 Hospital, Beijing, 100074, China.
Reprod Sci. 2024 Dec;31(12):3779-3794. doi: 10.1007/s43032-024-01686-6. Epub 2024 Sep 23.
The prognostic nutritional index (PNI) has emerged as a potential predictor of clinical outcomes in various cancers. However, a quantativetily analysis of its role in endometrial cancer (EC) remains lacking. This meta-analysis aims to evaluate the prognostic value of PNI on the survival outcomes of patients with EC. A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science, Wanfang, and CNKI to identify relevant cohort studies. Studies were included if they provided sufficient data to calculate hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) based on PNI levels. Data extraction and quality assessment were performed independently by two reviewers. Pooled HRs with 95% confidence intervals (CIs) were calculated using a random-effects model to account for heterogeneity. A total of 10 studies, encompassing 3656 patients, met the inclusion criteria. The meta-analysis revealed that a low PNI was significantly associated with poorer OS (HR = 2.01, 95% CI = 1.62-2.49, p < 0.05; I = 54%) and PFS (HR = 2.75, 95% CI = 1.74-4.33, p < 0.05; I = 78%) in patients with EC. Subgroup analyses indicated that the prognostic impact of PNI was consistent in studies from Asian and non-Asian countries, and across studies with different ages of the patients, cutoff values of PNI, and follow-up duration (p for subgroup difference all > 0.05). In conclusion, the PNI is a prognostic marker for survival in patients with EC.
预后营养指数（PNI）已成为各种癌症临床结局的潜在预测指标。然而，其在子宫内膜癌（EC）中的作用仍缺乏定量分析。本荟萃分析旨在评估PNI对EC患者生存结局的预后价值。在PubMed、EMBASE、Web of Science、万方和知网进行了全面的文献检索，以识别相关的队列研究。如果研究提供了足够的数据来计算基于PNI水平的总生存期（OS）和无进展生存期（PFS）的风险比（HRs），则纳入研究。由两名审阅者独立进行数据提取和质量评估。使用随机效应模型计算合并的HRs及其95%置信区间（CIs），以考虑异质性。共有10项研究，涵盖3656例患者，符合纳入标准。荟萃分析显示，低PNI与EC患者较差的OS（HR = 2.01，95% CI = 1.62 - 2.49，p < 0.05；I = 54%）和PFS（HR = 2.75，95% CI = 1.74 - 4.33，p < 0.05；I = 78%）显著相关。亚组分析表明，PNI的预后影响在来自亚洲和非亚洲国家的研究中以及在不同患者年龄、PNI截断值和随访持续时间的研究中是一致的（亚组差异的p值均> 0.05）。总之，PNI是EC患者生存的预后标志物。
