术后PNI在胃癌患者预后评估中的临床价值

doi:10.16689/j.cnki.cn11-9349/r.2020.03.012

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摘要目的探讨术后PNI在胃癌患者预后评估中的临床价值。方法回顾性分析术后胃癌Ⅲ期患者91例，根据术后、首次化疗前的外周血液指标计算出PNI、外周血中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、全身炎症指数（SII）等营养综合指标，通过ROC曲线计算出PNI最佳截断值。根据PNI最佳截断值将其分为低PNI组（PNI<42.3）和高PNI组（PNI≥42.3），根据PNI分组预测胃癌患者的预后。应用Cox回归模型进行单因素回归分析和多因素分析。结果多因素分析结果显示术后PNI（P=0.004）及分期（P=0.009）是影响胃癌患者总生存时间的独立预后因素。结论术后PNI是预测胃癌患者预后的独立因素，且低PNI和高分期与患者预后不良相关。

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	吴平
	杜仁佳
	俞筠
	葛晓松

Abstract：Objective The prognostic nutritional index(PNI) is used as a prognostic factor in gastric cancer(GC). Through this retrospective study, we aim to investigate the relationship between the postoperative PNI and prognosis of patients with stage Ⅲ GC. Methods The subjects of this retrospective study were 91 patients who underwent resection for stage Ⅲ GC, according to the first chemotherapy after surgery, calculated nutrient comprehensive index, such as PNI, NLR, PLR, SII. Time-dependent receiver operating characteristic curve analyses were used to assess discrimination ability and to determine the optimal cut-off values. Results According to the optimal cut-off value, they were divided into the low PNI group (PNI<42.3) and the high PNI group (PNI≥42.3).According to the staging, they were divided into Ⅲa, Ⅲb and Ⅲc three substages. All the inflammation-based and/or the nutritional markers of patients of stage Ⅲ GC, multivariate analyses demonstrated PNI and staging were independent prognostic factors for OS (P=0.004 and P=0.009, respectively). Conclusion PNI is an independent prognostic factor for the prognosis of postoperative chemotherapy patients with gastric cancer, and low PNI and high sub-staging were associated with poor prognosis.

基金资助:国家自然科学基金项目（81502042）

通讯作者: 葛晓松，电子邮箱：85410328@qq.com

引用本文:

吴平，杜仁佳，俞筠，葛晓松. 术后PNI在胃癌患者预后评估中的临床价值[J]. 肿瘤代谢与营养电子杂志, 2020, 7(3): 312-316.
Wu Ping, Du Renjia, Yu Yun,Ge Xiaosong. Clinical value of postoperative PNI in prognosis assessment of gastric cancer patients. Electron J Metab Nutr Cancer, 2020, 7(3): 312-316.

1.许静涌, 杨剑, 陈伟, 等. 老年肿瘤住院患者营养不良的横断面调查［J］. 中华老年医学杂志, 2019, 38(11):1298-1303.
2.阮强, 崔书中, 张相良, 等. 影响Ⅲ～Ⅳ期胃癌患者生存及预后因素:附156例报道［J］. 中国医师杂志, 2016, 18(8):1185-1189.
3.郑朝旭. 中国2009年胃癌发病与死亡分析［J］. 中国肿瘤, 2013, 22(5):327-332.
4.WANG Z, XU H, WANG S, et al. Relationship between new TNM classification and the prognosis and biological behavior of gastric cancer ［J］. Chin J Sur, 2000, 38(7):493-495.
5.GAO Z M, WANG R Y, DENG P, et al. TNM-PNI: a novel prognostic scoring system for patients with gastric cancer and curative D2 resection［J］. Cancer Manag Res, 2018, 28(10):2925-2933.
6.NA B G, HAN S S, CHO Y A, et al. Nutritional status of patients with cancer: a prospective cohort study of 1,588 hospitalized patients［J］. Nutr Cancer, 2018, 70(8):1228-1236.
7.SAGAWA M, KATSUBE T, KONNO S, et al. The significance of Onoderas prognostic nutritional index for the treatment of gastrointestinal cancer［J］. Gan to Kagaku Ryoho Cancer & Chemotherapy, 2008, 35(12):2253-2255.
8.WATANABE M, IWATSUKI M, IWAGAMI S, et al. Prognostic nutritional index predicts outcomes of gastrectomy in the elderly［J］. World J Sur, 2012, 36(7):1632-1639.
9.MIRILI C, YLMAZ A, DEMIRKAN S, et al. Clinical significance of prognostic nutritional index (PNI) in malignant melanoma［J］. International J Clin Oncology, 2019, 24(10):1301-1310.
10.叶欣, 于健春, 康维明, 等. 预后营养指数与胃癌临床病理特征及预后的关系［J］. 中华普通外科杂志, 2014, 29(2):93-97.
11.LEE J Y, KIM H I, KIM Y N, et al. Clinical significance of the prognostic nutritional index for predicting short-and long-term surgical outcomes after gastrectomy［J］. Medicine, 2016, 95(18):e3539.
12.ONODERA T, GOSEKI N, KOSAKI G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients［J］. Nihon Geka Gakkai Zasshi, 1984,85(9):1001-1005.
13.MIGITA K, TAKAYAMA T, SAEKI K, et al. The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage［J］. Ann Surg Oncol, 2013, 20(8):2647-2654.
14.SAITO H, KONO Y, MURAKAMI Y, et al. Postoperative serum albumin is a potential prognostic factor for older patients with gastric cancer［J］. Yonago Acta Medica, 2018, 61(1):72-78.
15.YANCHUN J, CHUNMING Y, KEYU R, et al. Effects of post-surgical parenteral nutrition on patients with gastric cancer［J］. Cell Physio & Biochem, 2018, 49(4):1320-1328.
16.秦楠, 姜桂春. 肿瘤化疗患者营养不良现状及研究进展［J］. 肿瘤代谢与营养电子杂志, 2018, 5(2):117-121.
17.LIU Z, JIN K, GUO M, et al. Prognostic aalue of the CRP/Alb ratio, a novel inflammation-based score in pancreatic Cancer［J］. Ann Surg Oncol, 2017, 24(2):561-568.
18.FAN H, SHAO Z Y, XIAO Y Y, et al. Comparison of the Glasgow Prognostic Score (GPS) and the modified Glasgow Prognostic Score (mGPS) in evaluating the prognosis of patients with operable and inoperable non-small cell lung cancer［J］. J Cancer Res & Clin Oncology, 2016, 142(6):1-13.
19.CHEN P, FANG M, WAN Q, et al. High-sensitivity modified Glasgow prognostic score (HS-mGPS) is superior to the mGPS in esophageal cancer patients treated with chemoradiotherapy［J］. Oncotarget, 2017, 8(59):99861-99870.
20.GANG T B, HANLEY G A, AGRAWAL A, et al. C-reactive protein protects mice against pneumococcal infection via both phosphocholine-dependent and phosphocholine-independent mechanisms［J］. Infection & Immunity, 2015, 83(5):1845-1852.
21.ZHU J, WANG H, LIU C C, et al. The Glasgow Prognostic Score (GPS) is a novel prognostic indicator in advanced epithelial ovarian cancer: a multicenter retrospective study［J］. J Cancer Res & Clin Oncology, 2016, 142(11):1-7.
22.ABE T, TASHIRO H, KOBAYASHI T, et al. Glasgow Prognostic Score and prognosis after hepatectomy for hepatocellular carcinoma［J］. World J Surg, 2017, 41(7):1860-1870.
23.SUN Y, ZHANG L. The clinical use of pretreatment NLR, PLR, and LMR in patients with esophageal squamous cell carcinoma: evidence from a meta-analysis［J］. Cancer Manag Res, 2018, 10:6167-6179.
24.Zhong J H, Huang D H, Chen Z Y. Prognostic role of systemic immune-inflammation index in solid tumors: A systematic review and meta-analysis［J］. Oncotarget, 2017, 8(43):75381-75388.
25.DUAN J, PAN L, YANG M, et al. Preoperative elevated neutrophil-to-lymphocyte ratio (NLR) and derived NLR are associated with poor prognosis in patients with breast cancer: A meta-analysis［J］. Medicine, 2018, 97(49)e13340.
26.YODYING H, MATSUDA A, MIYASHITA M, et al. Prognostic significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in oncologic outcomes of esophageal cancer: a systematic review and meta-analysis［J］. Ann Surg Oncol, 2016, 23(2):646-654.
27.ZHANG J, ZHANG H Y, LI J, et al. The elevated NLR, PLR and PLT May predict the prognosis of patients with colorectal cancer: a systematic review and meta-analysis［J］. Oncotarget, 2015, 8(40):68837-68846.
28.RAJWA P, YCZKOWSKI M, PARADYSZ A, et al. Evaluation of the prognostic value of LMR, PLR, NLR, and dNLR in urothelial bladder cancer patients treated with radical cystectomy［J］. Eur Rev Med Pharmacol Sci, 2018, 22(10):3027-3037.
29.JUN J H, YOO J E, LEE J A, et al. Anemia after gastrectomy in long-term survivors of gastric cancer: A retrospective cohort study［J］. Int J Surg, 2016, 28:162-168.
30.WADA T, KUNISAKI C, ONO H A, et al. Implications of BMI for the prognosis of gastric cancer among the japanese population［J］. Dig Sur, 2015, 32(6):480-486.
31.杜泽东, 张璇, 王定平, 等. 体重指数与胃癌根治术后预后关系［J］. 医学研究生学报, 2019, 32(3):40-44.