Significance of the prognostic nutritional index in patients with esophageal squamous cell carcinoma.
Significance of the prognostic nutritional index in patients with esophageal squamous cell carcinoma.
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DOI：
10.2147/tcrm.s56159
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发表时间：
2014
影响因子：
2.8
通讯作者：
Chen QX
中科院分区：
文献类型：
--
作者：
Feng JF;Chen QX
预后营养指数（PNI）与许多癌症的预后有关，但其在食管癌中的作用仍有争议。此外，关于PNI预测生存的最佳截止点存在争议。本研究的目的是确定PNI的预后价值，并提出PNI预测食管鳞状细胞癌（ESCC）癌症特异性生存（CSS）的最佳截断点。这项回顾性研究纳入了375例因ESCC接受食管切除术的患者。PNI计算为10 ×血清白蛋白（g/dL）+ 0.005 ×总淋巴细胞计数（每mm 3）。在散点图上的拟合线的帮助下，我们根据PNI将患者分为三类，即>52，42-52和<42。我们的研究显示PNI与肿瘤长度（P=0.007）、T分级（P=0.001）和N分期（P<0.001）相关。PNI <42、42-52和>52的5年生存率分别为11.0%、39.1%和55.2%（P<0.001）。多因素分析显示，PNI是CSS的显著预测因子（42-52 vs>52，P=0.011; <42 versus PNI >52，P<0.001）。PNI是食管鳞癌长期生存的预测因子。食管鳞癌的生存率可分为三组，即PNI <42、42-52和>52。
The prognostic nutritional index (PNI) is related to the prognosis in many cancers; however, its role in esophageal cancer is still controversial. Further, controversy exists concerning the optimal cut-off points for PNI to predict survival. The aim of this study was to determine the prognostic value of PNI and propose the optimal cut-off points for PNI in predicting cancer-specific survival (CSS) in esophageal squamous cell carcinoma (ESCC). This retrospective study included 375 patients who underwent esophagectomy for ESCC. The PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). With the help of the fit line on the scatter plot, we classified the patients into three categories according to the PNI, ie, >52, 42–52, and <42. Our study showed that PNI was associated with tumor length (P=0.007), T grade (P=0.001), and N staging (P<0.001). The 5-year CSS in patients with PNI <42, 42–52, and >52 were 11.0%, 39.1%, and 55.2%, respectively (P<0.001). Multivariate analysis showed that PNI was a significant predictor of CSS (42–52 versus >52, P=0.011; <42 versus PNI >52, P<0.001). PNI is a predictive factor for long-term survival in ESCC. The survival rate of ESCC can be discriminated between three groups, ie, PNI <42, 42–52, and >52.