Fang Linfu, Chen Ziwei
Linfu Fang Department of Hepatobiliary, Pancreas, Thyroid and Breast Surgery, Sanmen People's Hospital, Taizhou City, Zhejiang Province 317100, P.R. China.
Ziwei Chen Department of Cardiovascular Medicine, Sanmen People's Hospital, Taizhou City, Zhejiang Province 317100, P.R. China.
Pak J Med Sci. 2025 Apr;41(4):1244-1252. doi: 10.12669/pjms.41.4.11962.
The geriatric nutritional risk index (GNRI) has found utility as a predictor of outcomes in several malignancies. However, does it predicts outcomes in hepatocellular cancer (HCC) is unclear. In this review, we present high-quality evidence on the prognostic ability of GNRI for HCC.
Two reviewers screened the websites of Embase, PubMed, Web of Science, and Scopus up to 20 June 2024 for relevant articles. We examined overall survival (OS) and progression-free survival (PFS) based on low vs high GNRI in HCC.
Total 13 studies were included. Meta-analysis of 11 studies showed that low GNRI was significantly associated with poor OS (HR: 1.83 95% CI: 1.47, 2.29 I=67%) and PFS (HR: 1.51 95% CI: 1.34, 1.69 I=27%.) in HCC patients. No publication bias was noted. Most outcomes did not change on subgroup analysis based on country of origin, sample size, Child-Pugh Grade-B %, treatment, cut-off, follow-up, and method of analysis. Results remained significant on sensitivity analysis.
The GNRI can predict OS and PFS in HCC patients. Given its availability and ease of calculation, the tool can be incorporated into clinical practice to rapidly predict the prognosis of HCC patients.
老年营养风险指数（GNRI）已被证明可用于预测多种恶性肿瘤的预后。然而，它是否能预测肝细胞癌（HCC）的预后尚不清楚。在本综述中，我们提供了关于GNRI对HCC预后预测能力的高质量证据。
两名研究者检索了截至2024年6月20日Embase、PubMed、Web of Science和Scopus网站上的相关文章。我们根据HCC患者GNRI的高低来研究总生存期（OS）和无进展生存期（PFS）。
共纳入13项研究。对11项研究的荟萃分析表明，低GNRI与HCC患者较差的OS（风险比：1.83，95%置信区间：1.47，2.29，I=67%）和PFS（风险比：1.51，95%置信区间：1.34，1.69，I=27%）显著相关。未发现发表偏倚。基于原产国、样本量、Child-Pugh B级百分比、治疗、临界值、随访和分析方法的亚组分析中，大多数结果没有变化。敏感性分析结果仍然显著。
GNRI可以预测HCC患者的OS和PFS。鉴于其可用性和易于计算，该工具可纳入临床实践，以快速预测HCC患者的预后。
