食管癌成年患者术后预后免疫营养指数与无病生存期的关联：一项回顾性队列研究。
Association between prognostic immune nutritional index and disease-free survival in adults with esophageal cancer following surgery: A retrospective cohort study.
作者信息
Yamashita Shinji, Okugawa Yoshinaga, Kitajima Takahito, Ieki Hideharu, Shimamura Mai, Ma Ruiya, Higashi Koki, Mizuno Naru, Sato Yuki, Ichikawa Takashi, Uratani Ryo, Shimura Tadanobu, Imaoka Hiroki, Kawamura Mikio, Yasuda Hiromi, Koike Yuhki, Okita Yoshiki, Yoshiyama Shigeyuki, Ohi Masaki, Toiyama Yuji
机构信息
Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan.
Department of Genomic Medicine, Mie University Hospital, Tsu, Japan.
出版信息
JPEN J Parenter Enteral Nutr. 2025 May;49(4):497-506. doi: 10.1002/jpen.2740. Epub 2025 Mar 6.
INTRODUCTION
The clinical significance of the prognostic immune nutritional index in esophageal cancer has not been elucidated. The aim of this study was to evaluate the utility of the preoperative prognostic immune nutritional index in predicting oncological outcomes and the incidence of surgical site infection in patients with esophageal cancer.
METHODS
We analyzed preoperative prognostic immune nutritional index from 150 esophageal cancer patients who underwent surgical treatment between 2008 and 2018 to clarify its clinical relevance.
RESULTS
Patients with low preoperative prognostic immune nutritional index exhibited poor disease-free survival and overall survival (P = 0.030 and P < 0.001, respectively). Although statistical significance was not observed in the multivariate analysis, low prognostic immune nutritional index showed a tendency toward poorer disease-free survival (hazard ratio [HR]: 2.02; 95% confidence interval [CI]: 0.88-4.61; P = 0.096). Regarding overall survival, multivariate analysis revealed that low preoperative prognostic immune nutritional index was an independent prognostic factor for overall survival (HR: 2.67; 95% CI: 1.39-5.16; P = 0.003). Moreover, the low preoperative prognostic immune nutritional index was associated with a tendency toward an increased risk of surgical site infection (odds ratio: 2.38; 95% CI: 0.96-5.91; P = 0.062). In the subgroup analysis of patients who did not receive neoadjuvant therapy, low preoperative prognostic immune nutritional index was identified as an independent prognostic factor for disease-free survival (HR: 3.11; 95% CI: 1.00-9.71; P = 0.050) and overall survival (HR: 5.04; 95% CI: 1.80-14.13; P = 0.002).
CONCLUSION
The preoperative prognostic immune nutritional index is a useful marker for perioperative and oncological management of esophageal cancer patients.
引言
食管癌预后免疫营养指数的临床意义尚未阐明。本研究的目的是评估术前预后免疫营养指数在预测食管癌患者肿瘤学结局及手术部位感染发生率方面的效用。
方法
我们分析了2008年至2018年间接受手术治疗的150例食管癌患者的术前预后免疫营养指数，以阐明其临床相关性。
结果
术前预后免疫营养指数低的患者无病生存期和总生存期较差（分别为P = 0.030和P < 0.001）。虽然在多变量分析中未观察到统计学意义，但预后免疫营养指数低显示出无病生存期较差的趋势（风险比[HR]：2.02；95%置信区间[CI]：0.88 - 4.61；P = 0.096）。关于总生存期，多变量分析显示术前预后免疫营养指数低是总生存期的独立预后因素（HR：2.67；95% CI：1.39 - 5.16；P = 0.003）。此外，术前预后免疫营养指数低与手术部位感染风险增加的趋势相关（比值比：2.38；95% CI：0.96 - 5.91；P = 0.062）。在未接受新辅助治疗的患者亚组分析中，术前预后免疫营养指数低被确定为无病生存期（HR：3.11；95% CI：1.00 - 9.71；P = 0.050）和总生存期（HR：5.04；95% CI：1.80 - 14.13；P = 0.002）的独立预后因素。
结论
术前预后免疫营养指数是食管癌患者围手术期和肿瘤学管理的有用标志物。
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