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| The nutritional immune and inflammation related parameters for non‑small cell lung cancer patients |
| Wang Xiaolan, Han Wei, Wang Ying |
| Department of Thoracic Surgery, Hai'an Hospital, Nantong University, Hai'an 226600, Jiangsu, China |
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Abstract Objective To evaluate the prognostic value of three nutritional⁃immune and inflammation⁃related parameters, including
prognostic nutritional index (PNI), Glasgow prognostic score (GPS) and controlling nutritional status (CONUT), for non⁃small cell
lung cancer (NSCLC) patients. Methods A total of 186 NSCLC patients who were treated with curative resection in our hospital from
September 2014 to May 2018 were included in this study. All patients were divided into study groups based on different nutritional⁃and
immune⁃related parameters. The prognostic value of PNI, GPS and CONUT for NSCLC patients was determined by Kaplan⁃Meier
survival curve and receiver operation characteristics (ROC) curve, respectively. Moreover, the Cox multivariate regression analysis
was used to identify the independent prognostic factors for NSCLC patients. Results All NSCLC patients were divided into two groups
based on the CONUT score, and the results showed that the overall survival (OS) of patients with CONUT≥2 was significantly shorter
than that of patients with CONUT 0~1. The 3⁃year OS of two study groups was 70.6% and 94.0%, respectively (χ²=29.249, P<0.001),
with a significantly statistical difference. Similarly, patients were divided into PNI>45.0 and PNI≤ 45.0 group based on the cut⁃off
value of PNI. The results indicated that low PNI was significantly correlated to the poor OS of NSCLC patients (3⁃year OS: 66.5%
vs 92.6%，χ²=28.686, P<0.001). Additionally, Kaplan⁃Meier curves showed that the 3⁃year OS of GPS 2 and GPS 0-1 group was
61.7% and 90.7%, respectively. There was a significantly statistical difference between the two groups (χ²=18.499, P<0.001). ROC
curve showed that the area under curve (AUC) of CONUT, PNI and GPS was 0.753 (95%CI=0.659~0.846), 0.734 (95%CI=0.629~ 0.839) and 0.669 (95%CI=0.552~0.786), respectively. The results of multivariate Cox analysis demonstrated that CONUT (HR=4.068
and 95%CI=1.310~12.631, P=0.015), PNI (HR=4.043 and 95%CI=1.585~10.307, P=0.003) and TNM stage (HR=2.428, 95%CI=1.153~ 5.111, P=0.020) were independently risk factors to the prognosis of NSCLC patients. Conclusion Both PNI and CONUT were
independent prognostic factors for NSCLC patients, and they could be used as simple and useful parameter for prognostic prediction
of NSCLC patients.
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Received: 30 April 2021
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