|
|
|
| To explore the predictive value of prognostic nutrition index (PNI) for clinical outcomes in selective surgery of gastrointestinal tumors |
| 1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Clinical Nutrition, Peking University Cancer Hospital & Institute, Beijing 100142, China; 2Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Surgery Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China |
|
|
|
|
Abstract Objective To explore the application value of prognostic nutrition index (PNI) in gastrointestinal cancer patients by comparing with nutritional screening tool NRS 2002 and nutrition assessment tool PG-SG. Methods A prospective application of nutritional screening or assessment tools PNI, NRS 2002 and PG-SGA, into a group of unconsecutive cases of gastrointestinal cancer patients were carried. To draw the receiver operating characteristic (ROC) curve of PG-SGA and PNI according to NRS 2002 results, analyzing the difference between tools involving sensitivity and specificity, positive predictive value, negative predictive value, Yueden index and the area under the curve. To compare the nutrition related indicators between the two groups divided by the cutoff point. The Kappa test was used to compare the diagnostic consistency between the different diagnosing tools. Results The area under the PG-SGA curve is 0.936 (95%CI=0.893~0.979), the Yueden index is 0.778, the cut-off value is 7.5, the sensitivity is 84.6%, the specificity is 93.2%, the positive predictive value is 97.3%, and the negative predictive value is 52,8%. Consistency was checked P=0.000. Maximum value of PNI was 75.6, and minimum value 29.35. ROC curve showed that area under the PNI curve was 0.584 (95%CI=0.480~0.688), the Yueden index is 0.196, the cut-off value of PNI is 53.8, the diagnostic sensitivity was 89.7% by this cutoff point , specificity was 29.9%, the positive predictive value was 63.2% and negative predictive value was 13.3%. The consistency test with NRS 2002 P=0.015. The patients were divided into two groups (by cut-off value PNI=53.8), there were statistically significant difference of weight, height, ALb and TLC between the two groups (P<0.05). While BMI and TLC had significant difference between the two groups devided by PG-SGA≥8 (P < 0.05). The consistency between the two methods of PG-SGA and PNI is P=0.000. There was no statistically significant difference about the total incidence of complications between the two groups divided by three evaluation tools (P>0.05). Conclusions For patients with surgical gastrointestinal tumor, PNI=53.8 can serve as a cut-off diagnostic threshold for nutritional risk with more significant difference in related nutritional indexes. There was no significant difference in the total incidence of postoperative complications between the two groups districted by the three tools respectively.
|
|
|
|
|
|
|
|
|
2019, Vol. 6 
