Yamanaka-Kohno Reiko, Shirakawa Yasuhiro, Inoue-Minakuchi Mami, Yokoi Aya, Noma Kazuhiro, Tanabe Shunsuke, Maeda Naoaki, Fujiwara Toshiyoshi, Morita Manabu, Ekuni Daisuke
Department of Preventive Dentistry, Division of Dentistry, Okayama University Hospital, Okayama 700-8558, Japan.
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Nutrients. 2024 Dec 19;16(24):4383. doi: 10.3390/nu16244383.
A high prognostic nutritional index (PNI) is associated with good prognosis in patients with esophageal cancer. However, nutritional status often decreases during neoadjuvant therapy. Functional tooth units (FTUs) provide an index for the status of posterior occlusal support. We have previously reported that low PNI is related to low FTUs. The purpose of this study was to retrospectively examine whether the status of occlusal support relates to changes in PNI during neoadjuvant therapy in patients with esophageal cancer. This study included 34 patients who underwent neoadjuvant therapy before esophagectomy (32 men, 2 women; age, 36-82 years) in 2012 at Okayama University Hospital. Patients were divided into the good occlusal support group (FTUs ≥ 11, = 18) or poor occlusal support group (FTUs < 11, = 16), and changes in PNI during neoadjuvant therapy were investigated. PNI decreased significantly after neoadjuvant therapy, particularly in the good occlusal support group, and became more dispersed after neoadjuvant therapy. Decreases in PNI after neoadjuvant therapy showed a significant positive correlation with good occlusal support by multiple regression analysis ( = 0.03). The proportions of patients provided with nutritional intervention ( = 0.02) or early dental intervention ( = 0.04) were lower in the good occlusal support group than in the poor occlusal support group. Even in patients with esophageal cancer with good occlusal support experienced significant declines in PNI during neoadjuvant therapy, potentially due to delayed nutritional and dental interventions. Early multidisciplinary interventions are thus recommended for all patients, regardless of preoperative dental or nutritional status.
高预后营养指数（PNI）与食管癌患者的良好预后相关。然而，在新辅助治疗期间营养状况常下降。功能性牙单位（FTUs）为后牙咬合支持状况提供了一个指标。我们之前曾报道低PNI与低FTUs相关。本研究的目的是回顾性研究食管癌患者在新辅助治疗期间咬合支持状况是否与PNI的变化有关。本研究纳入了2012年在冈山大学医院接受食管癌切除术前新辅助治疗的34例患者（32例男性，2例女性；年龄36 - 82岁）。患者被分为良好咬合支持组（FTUs≥11，n = 18）或不良咬合支持组（FTUs < 11，n = 16），并研究新辅助治疗期间PNI的变化。新辅助治疗后PNI显著下降，尤其是在良好咬合支持组，且新辅助治疗后变得更加分散。通过多元回归分析，新辅助治疗后PNI的下降与良好咬合支持呈显著正相关（P = 0.03）。良好咬合支持组接受营养干预（P = 0.02）或早期牙科干预（P = 0.04）的患者比例低于不良咬合支持组。即使是咬合支持良好的食管癌患者在新辅助治疗期间PNI也显著下降，这可能是由于营养和牙科干预延迟所致。因此，建议对所有患者进行早期多学科干预，无论术前牙齿或营养状况如何。
