Serum Marker Score Based on Prognostic Nutrition Index, Carcinoembryonic Antigen, and Carbohydrate Antigen 19-9 Is Associated With Recurrence for Patients Undergoing Surgery for Pancreatic Ductal Adenocarcinoma
Serum Marker Score Based on Prognostic Nutrition Index, Carcinoembryonic Antigen, and Carbohydrate Antigen 19-9 Is Associated With Recurrence for Patients Undergoing Surgery for Pancreatic Ductal Adenocarcinoma
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DOI：
10.1097/mpa.0000000000001146
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发表时间：
2018-10-01
期刊：
影响因子：
2.9
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
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作者：
Nakagawa, Shigeki;Yamashita, Yo-ichi;Baba, Hideo
目的预后营养指数（PNI）对胰腺导管腺癌（PDAC）的预后价值仍有争议。本研究旨在评估PNI与PDAC患者预后之间的相关性，并从PNI和血清标志物中产生新的评分。方法对2002年4月至2012年6月间行胰腺切除术的151例PDAC患者进行研究。根据PNI值分析无病生存期（DFS）、总生存期和临床病理参数。结果低PNI患者的5年DFS率低于高PNI患者（分别为10.7%和34.8%）。多因素分析显示，DFS较差的独立危险因素为高癌胚抗原（HR, 1.53; P = 0.038）、高碳水化合物抗原19-9 （HR, 1.67; P = 0.017）、淋巴结转移阳性（HR, 1.98; P = 0.017）、R1或2切除（HR, 3.50; P < 0.001）和低PNI (HR， 0.37[高/低]，P = 0.029]。基于公式-0.49 x (PNI) + 0.41 x（癌胚抗原）+ 0.67 x（碳水化合物抗原19-9）的评分与较差的DFS （P < 0.001）和总生存率（P = 0.0019）显著相关。结论低PNI和血清标志物评分与低DFS有显著相关性。
Objectives The prognostic value of the prognostic nutrition index (PNI) in pancreatic ductal adenocarcinoma (PDAC) is still controversial. This study aimed to assess the correlation between PNI and the outcome for PDAC patients and to generate a new score from PNI and serum markers.Methods This study investigated 151 patients who underwent pancreatic resection for PDAC between April 2002 and June 2012. Disease-free survival (DFS), overall survival, and clinicopathological parameters were analyzed according to the PNI value.Results The low PNI patients had poorer 5-year DFS rate than high-PNI patients (10.7% and 34.8%, respectively). Multivariate analyses revealed that independent risk factors for poor DFS were high carcinoembryonic antigen (hazard ratio [HR], 1.53; P = 0.038), high carbohydrate antigen 19-9 (HR, 1.67; P = 0.017), positive lymph node metastasis (HR, 1.98; P = 0.017), R1 or 2 resection (HR, 3.50; P < 0.001), and low PNI (HR, 0.37 [high/low]; P = 0.029]. Scoring based on the formula -0.49 x (PNI) + 0.41 x (carcinoembryonic antigen) + 0.67 x (carbohydrate antigen 19-9) was significantly associated with poor DFS (P < 0.001) and overall survival (P = 0.0019).Conclusions Low PNI and serum marker score are significantly associated with poor DFS.