术前炎症和营养预后指数与结直肠癌近期疗效  

Evaluation of Preoperative Prognostic Inflammatory and Nutritional Index on Short-Term Prognosis of Colorectal Cancer

作　　者：刘丹[1] 汪晓东[2] 邓磊[1] 吕东昊[1] 董慧[1] 牛洁[1] 纳飞飞[1] 李立[2] 

机构地区：[1]四川大学华西临床医学院/华西医院MCQ团队,成都610041 [2]四川大学华西医院胃肠外科中心,成都610041

出　　处：《中国普外基础与临床杂志》2009年第11期934-938,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川省卫生厅科研课题(项目编号:090356)~~

摘　　要：目的探讨结直肠癌患者术前炎症和营养预后指数(prognostic inflammatory and nutritional index,PINI)水平与近期疗效的关系。方法前瞻性纳入2009年4～6月期间经病理检查诊断为结直肠癌的住院患者。所有患者均于术前3d测定血清α1-酸性糖蛋白、C-反应蛋白、白蛋白和前白蛋白水平,并以此计算术前PINI值。分析术前PINI水平与患者病理分期、术后并发症、生活质量及复发转移的关系。结果本研究共纳入结直肠癌患者38例,均接受了根治性手术治疗,术前PINI水平平均为2.17±1.27。术前PINI水平与病理TNM分期及M分期有关:Ⅳ期患者的PINI水平明显高于Ⅰ、Ⅱ及Ⅲ期(P<0.001),M1期患者的PINI水平亦明显高于M0期(P<0.001)。术前PINI水平与患者术后并发症的发生无关(P>0.05)。术前PINI水平与患者术后的厌食情况、饮食总体情况及生存质量的总体评估水平有关:饮食不正常者或有厌食情况者,其PINI水平明显高于饮食正常者(P=0.020)或无厌食情况者(P=0.020);生存质量"差"者,其PINI水平明显高于生存质量"好"(P=0.020)及"一般"(P=0.025)者。结论术前PINI可以作为结直肠癌患者短期预后的评估指标之一。Objective To determine the relationship between preoperative prognostic inflammatory and nutritional index （PINI） value and short-term prognosis in colorectal cancer. Methods Patients with colorectal cancer verified by pathologically examine were prospectively enrolled from April 2009 to June 2009. Serum alpha-1-acid glycoprotein, C-reactive protein, albumin and prealbumin were examined on day 3 before operation, and the value of preoperative PINI was calculated. The relationships between preoperative PINI and patho-TNM stage, complications, quality of life, and recurrence and metastasis after operation were analyzed. Results Total 38 patients with colorectal cancer underwent radical surgery were enrolled. Preoperative PINI value was 2. 17±1.27. Preoperative PINI value was correlated with TMN stage and M stage： PINI value in patients of IV stage or M1 stage, were significantly higher than those in ones of Ⅰ , Ⅱ and Ⅲ stage （P〈0. 001） or M0 stage （P〈0. 001）. There was no significant correlation between preoperative PINI value and preoperative complications （P〉0.05）. Preoperative PINI value was correlated with postoperative diet, anorexia and overall quality of life： preoperative PINI value in patients with abnormal diet, anorexia or poor quality of life, were significantly higher than those in ones with normal diet （P=0. 020）, no-anorexia （P=0. 020） or moderate （P=0. 025） and well （P=0. 020） quality of life. Conclusion Preoperative PINI value is an effective index to assess the short-term prognosis of colorectal cancer.

关 键 词：结直肠癌 炎症和营养预后指数 术前评估 预后 

分 类 号：R735.3[医药卫生—肿瘤]