The combination of pretreatment prognostic nutritional index and neuron-specific enolase enhances prognosis predicting value of small cell lung cancer
The combination of pretreatment prognostic nutritional index and neuron-specific enolase enhances prognosis predicting value of small cell lung cancer
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治疗前预后营养指数与神经元特异性烯醇化酶联合增强小细胞肺癌预后预测价值
DOI：
10.1111/crj.13291
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发表时间：
2020-11-01
影响因子：
1.7
通讯作者：
Cao, Shoubo
中科院分区：
文献类型：
--
作者：
Wang, Chunyan;Jin, Shi;Cao, Shoubo
肿瘤和免疫炎症生物标志物已被证明与癌症预后密切相关。目的探讨预处理预后营养指数（PNI）、癌胚抗原（CEA）和神经元特异性烯醇化酶（NSE）在小细胞肺癌（SCLC）中的预后价值。方法对301例接受铂类化疗的SCLC患者进行回顾性分析。通过Kaplan-Meier和多变量Cox风险分析评估总生存期（OS）。结果总病例中位OS为15.0个月。单因素分析发现，肿瘤分期（P < 0.001）、预处理PNI （P < 0.001）、CEA （P = 0.039）、NSE （P = 0.010）、远处转移数（P < 0.001）和胸部放疗（P < 0.001）是OS的预测因子。多因素分析显示分期有限、PNI高、NSE < 15 μ g/L、放化疗为阳性独立预后因素（P < 0.05）。低PNI和NSE >= 15 μ g/L与高肿瘤负荷状态密切相关。根据不同的PNI和NSE水平将生存结果有显著差异的SCLC患者分为三个队列。高PNI和NSE < 15 mu g/L的患者生存期最佳为24.5个月，低PNI和NSE >= 15 mu g/L的患者生存期最差为10.0个月。低PNI和NSE < 15 μ g/L或高PNI和NSE >= 15 μ g/L的患者分别在16.5和17.0个月的结果相似。结论预处理PNI和NSE是SCLC的独立预后因素。PNI和NSE联合应用提高了OS的预测能力，高PNI和NSE < 15 μ g/L的患者生存结局最好。
Introduction Tumor and immune-inflammatory biomarkers have been demonstrated to be closely associated with cancer prognosis.Objective The present study aims to assess the prognostic value of pretreatment prognostic nutritional index (PNI), carcinoembryonic antigen (CEA), and neuron-specific enolase (NSE) in small cell lung cancer (SCLC).Methods A retrospective analysis of 301 SCLC patients treated with platinum-based chemotherapy was performed. Overall survival (OS) was assessed by Kaplan-Meier and multivariate Cox hazard analyses.Results The median OS for total cases was 15.0 months. On univariate analysis, tumor stage (P < 0.001), pretreatment PNI (P < 0.001), CEA (P = 0.039), NSE (P = 0.010), distant metastasis numbers (P < 0.001), and thoracic radiotherapy (P < 0.001) were found to be the predictors of OS. Multivariate analysis showed limited stage, high PNI, NSE < 15 mu g/L, and chemoradiotherapy were positive independent prognostic factors (P < 0.05). Low PNI and NSE >= 15 mu g/L were closely correlated with a high tumor burden status. Three cohorts of SCLC with significant different survival outcomes were divided based on variable PNI and NSE levels. Patients with high PNI and NSE < 15 mu g/L showed the best OS of 24.5 months, while patients with low PNI and NSE >= 15 mu g/L had the worst survival outcome of 10.0 months. Patients with low PNI and NSE < 15 mu g/L or high PNI and NSE >= 15 mu g/L had the similar outcome of 16.5 and 17.0 months, respectively.Conclusions Pretreatment PNI and NSE were independent prognostic factors of SCLC. The combination of PNI and NSE enhanced the OS predicting ability, and patients with high PNI and NSE < 15 mu g/L had the best survival outcome.