预后营养指数在胃癌患者术后预后判断中的应用  

The Application of Prognostic Nutritional Index in Predicting the Outcomes of Gastric Cancer Patients Accepted Gastrectomy

作　　者：李洲[1] 

机构地区：[1]四川省自贡市第一人民医院,四川自贡643000

出　　处：《肿瘤预防与治疗》2015年第5期249-252,共4页Journal of Cancer Control And Treatment

摘　　要：目的：探讨预后营养指数（prognostic nutritional index,PNI）与胃癌术后患者的不良反应发生及预后的关系。方法：回顾性分析2006年1月～2014年6月128例经病理确诊为胃癌并行胃癌根治切除术患者的临床随访病例资料。通过对ROC曲线得出PNI的最佳截断值,根据最佳截断值将患者分为PNI高值组及PNI低值组,比较两组的临床病理学特征。采用Cox比例风险模型研究胃癌术后患者预后的影响因素。结果：以PNI值=50.1为最佳截断值时,约登指数为最大值,敏感度为64.6%,特异度为34.5%。PNI低值组中年龄≥65岁、肿瘤大小≥5cm、侵袭深度为T3或T4、淋巴结转移、发生术后并发症的比例较高。多因素生存分析显示：PNI值、侵袭深度、淋巴结转移、术后并发症是胃癌患者术后预后的独立影响因素。结论：PNI值的计算简便,可用于初步判断胃癌患者术后的预后状况。Objective： To explore the application of prognostic nutritional index（ PNI） in predicting the postoperative complications and long-term outcomes in gastric cancer patients undergoing gastrectomy. Methods： The data for 128 patients with pathologically proved gastric cancer who accepted gastrectomy in our hospital between January 2006 and June2014 were extracted and analyzed. Subjects were divided into two groups according to the cutoff value of the PNI. Clinicopathological features were compared between the two groups and potential prognostic factors were analyzed. The Cox proportional hazard model was used to explore the influencing factors. Results： The optimal cutoff value of the PNI was set at〈50. 1,and patients with PNI≥50. 1 and those with PNI 50. 1 were classified into PNI-high and PNI-low groups,respectively. Patients in the PNI-low group were more likely to be older than 65 years old,had larger tumor size（ ≥5cm） and deeper invasion depth（ T3 and T4）,had lymph node metastasis（ N） and higher incidence of postoperative complications when comparing with those in the PNI-high group. The multivariate analyses showed that PNI value,depth of invasion,lymph node metastasis and postoperative complications were independent factors in predicting overall survival rate of patients who underwent gastrectomy. Conclusion： PNI is recommended to identify the prognosis of gastric cancer patients accepted gastrectomy with its easy way of calculation.

关 键 词：预后营养指数 胃癌 预后 

分 类 号：R735.2[医药卫生—肿瘤]