The Prognostic Nutritional Index Predicts Long-term Outcomes of Gastric Cancer Patients Independent of Tumor Stage
The Prognostic Nutritional Index Predicts Long-term Outcomes of Gastric Cancer Patients Independent of Tumor Stage
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DOI：
10.1245/s10434-013-2926-5
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发表时间：
2013-08-01
影响因子：
3.7
通讯作者：
Nakajima, Yoshiyuki
中科院分区：
文献类型：
--
作者：
Migita, Kazuhiro;Takayama, Tomoyoshi;Nakajima, Yoshiyuki
本研究旨在探讨预后营养指数（PNI）对胃癌患者长期预后的影响。本研究回顾了548例接受胃切除术的胃癌患者的医疗记录。PNI计算为10 ×血清白蛋白(g/dl) + 0.005 ×总淋巴细胞计数（每mm(3)）。采用受试者工作特征（ROC）曲线分析确定PNI的截止值。进行多因素分析以确定影响预后的因素。T3-T4肿瘤和淋巴结转移患者的平均PNI显著低于无上述因素的患者（P < 0.001）。术后并发症患者的平均PNI低于无并发症患者（P = 0.023）。当进行ROC曲线分析时，预测5年生存的最佳PNI截断值为48。在多变量分析中，低PNI是总生存差的独立预测因子（P < 0.001）。在亚组分析中，在I期和III期疾病患者中，低pni组的总生存率和无复发生存率显著低于高pni组。PNI是预测胃癌患者长期预后的一种简单而有用的标志物，与肿瘤分期无关。基于我们的研究结果，我们建议将PNI纳入胃癌患者的常规评估。
The aim of this study was to investigate the impact of the prognostic nutritional index (PNI) on the long-term outcomes in gastric cancer patients.This study reviewed the medical records of 548 patients with gastric cancer who underwent gastrectomy. The PNI was calculated as 10 x serum albumin (g/dl) + 0.005 x total lymphocyte count (per mm(3)). The receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff value of the PNI. The multivariate analysis was performed to identify the prognostic factors.The mean PNI was significantly lower in patients with T3-T4 tumors (P < 0.001) and lymph node metastasis (P < 0.001) than in those without such factors. Patients who had a postoperative complication had a lower mean PNI than those without (P = 0.023). When the ROC curve analysis was performed, the optimal cutoff value of the PNI for predicting the 5-year survival was 48. In the multivariate analysis, a low PNI was an independent predictor for poor overall survival (P < 0.001). In the subgroup analysis, the overall and relapse-free survival rates were significantly lower in the PNI-low group than in the PNI-high group among patients with stage I and stage III disease.The PNI is a simple and useful marker for predicting the long-term outcomes of gastric cancer patients independent of the tumor stage. Based on our results, we suggest that the PNI should be included in the routine assessment of gastric cancer patients.