Prognostic correlation between preoperative nutritional index and skeletal muscle area and prognosis of patients with gastric
cancer undergoing total gastrectomy
1Ming Fang,1Yu Yanzi,2Yu Yang
1Department of General Surgery the Sixth Hospital of Wuhan Affiliated Hospital of Jianghan University Wuhan 430014 Hubei
China
2 Department of Gastrointestinal Surgery the Sixth Hospital of Wuhan Affiliated Hospital of Jianghan University Wuhan
430014 Hubei China
Abstract：Objective To investigate the correlation between preoperative prognostic nutritional index PNI and skeletal muscle
area SMA and prognosis of patients with gastric cancer after total gastrectomy. Method A total of 109 patients with gastric cancer
who received total gastectomy in the Affiliated Hospital of Jianghan University / Wuhan Sixth Hospital from March 2019 to December
2020 and were followed up to December 2023 were selected as the study subjects and set as the gastric cancer group and 54 healthy
subjects were selected as the healthy control group. The changes of PNI and SMA between the two groups were compared. The
expressions of PNI and SMA in different pathological features of gastric cancer patients were observed. Spearman method was used to
analyze the correlation between PNI SMA and clinical features of gastric cancer patients. Cox proportional risk model was used to
analyze the effects of PNI and SMA on 3 - year progression - free survival and overall survival of gastric cancer patients. Receiver
operating characteristic ROC curve were drawn to analyze the area under the curve AUC sensitivity and specificity of SMA in
predicting the prognosis of patients with gastric cancer. Result PNI and SMA in gastric cancer group were lower than those in healthy
control group P<0. 05 . The PNI and SMA of gastric cancer patients with stage Ⅲ low differentiation T3-T4 infiltration lymph
node metastasis and vascular invasion were lower than those with stage Ⅰ to Ⅱ medium to high differentiation T1-T2 infiltration
and no lymph node metastasis and vascular invasion P < 0. 05 . Correlation analysis showed that PNI and SMA were negatively
correlated with clinical stage differentiation degree depth of invasion lymph node metastasis and vascular invasion P<0. 05 . Cox
proportional risk model multivariate analysis showed that the decrease of SMA was an independent factor for 3-year progression-free survival in patients with total gastrectomy for gastric cancer P< 0. 05 . ROC curve analysis showed that the AUC sensitivity and
specificity of SMA in predicting 3 -year progression -free survival of patients with total gastrectomy for gastric cancer were 0. 797
69. 90% and 83. 30% respectively. Conclusion PNI and SMA showed a significant downward trend in gastric cancer patients and
their levels changed with the severity of the patient 's disease and affected the prognosis. Dynamic detection of their changes was
conducive to providing guidance for clinical treatment and prognosis assessment. Decreased SMA was an independent factor for 3-year
progression-free survival in patients with total gastrectomy for gastric cancer
1明 芳,1余燕子,2余 阳. 术前预后营养指数及骨骼肌面积与胃癌胃全切除术患者预后的相关性[J]. 肿瘤代谢与营养电子杂志, 2025, 12(1): 52-59.
1Ming Fang,1Yu Yanzi,2Yu Yang. Prognostic correlation between preoperative nutritional index and skeletal muscle area and prognosis of patients with gastric
cancer undergoing total gastrectomy. Electron J Metab Nutr Cancer, 2025, 12(1): 52-59.
