预后营养指数与原发性肝癌患者临床病理特征及预后的关系  

The relationship between prognostic nutritional index and clinicopathological characteristics and prognosis of patients with primary hepatocellular carcinoma

作　　者：阿伊克玲·努尔拜克 纪文静[2] 李梦莹[2] 梁灿灿[2] 丁永年[2] Ayikeling Nuerbaike;JI Wenjing;LI Mengying;LIANG Cancan;DING Yongnian(The Second Clinical Medical College of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi 830000,China;Department of Gastroenterology,the Second Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi 830000,China)

机构地区：[1]新疆医科大学第二临床医学院,新疆乌鲁木齐830000 [2]新疆医科大学第二附属医院消化内科,新疆乌鲁木齐830000

出　　处：《中国医药导报》2019年第26期117-120,共4页China Medical Herald

基　　金：新疆维吾尔自治区自然科学基金资助项目（2018D01C241）

摘　　要：目的研究预后营养指数(PNI)与原发性肝癌患者临床病理特征及预后的关系。方法选取2010年1月~2015年3月新疆医科大学第二附属医院收治的原发性肝癌患者90例进行研究,根据PNI的不同分为低PNI组(PNI <45)60例与高PNI组(PNI≥45)30例,分析PNI与原发性肝癌患者一般资料的关系。此外,对所有患者进行为期3年的随访,分析3年总生存率与临床病理特征、PNI以及治疗方式的关系,并予以多因素Logistic回归分析。结果低PNI组年龄≥60岁、临床分期为Ⅲ~Ⅳ期人数占比较高PNI组高,差异有统计学意义(均P <0.05),两组性别、吸烟、饮酒、淋巴结转移比较差异无统计学意义(均P> 0.05)。经单因素分析发现:年龄、临床分期、淋巴结转移、PNI以及治疗方式均与原发性肝癌患者3年总生存率有关(均P <0.05)。经多因素Logistic回归分析可得:年龄≥60岁、临床分期为Ⅲ~Ⅳ期、有淋巴结转移、PNI<45以及非综合治疗均为原发性肝癌患者3年总生存率的独立危险因素(均P <0.05)。结论 PNI与原发性肝癌患者的年龄、临床分期及预后存在密切关系。此外,影响原发性肝癌患者预后的危险因素较多,临床上应针对此类因素进行科学监测或干预,从而更好地改善患者预后。Objective To study the relationship between prognostic nutritional index (PNI) and clinicopathological characteristics and prognosis of patients with primary hepatocellular carcinoma. Methods Ninety patients with primary liver cancer admitted to the Second Affiliated Hospital of Xinjiang Medical University from January 2010 to March 2015 were selected for the study. According to the difference of PNI, 60 cases of low PNI group (PNI < 45) and 30 cases of high PNI group (PNI ≥ 45) were divided into two groups. The relationship between PNI and the general data of patients with primary hepatocellular carcinoma was analyzed. In addition, all patients were followed up for 3 years. The relationship between 3-year overall survival rate and clinicopathological features, PNI and treatment modalities were analyzed. Multivariate Logistic regression analysis was used. Results The proportion of low PNI group with age over 60 years and clinical stage Ⅲ-Ⅳ were higher than those of PNI group, and the differences were statistically significant (all P < 0.05). There were no significant differences in gender, smoking, alcohol consumption and lymph node metastasis between two groups (all P > 0.05). Univariate analysis showed that age, clinical stage, lymph node metastasis, PNI and treatment were all related to the 3-year overall survival rate of patients with primary hepatocellular carcinoma (all P < 0.05). Multivariate Logistic regression analysis showed that age (> 60 years old), clinical stage Ⅲ-Ⅳ, lymph node metastasis, PNI < 45 and non-comprehensive treatment were independent risk factors for 3-year overall survival rate of patients with primary liver cancer (all P < 0.05). Conclusion PNI is closely related to the age and clinical stage of patients with primary hepatocellular carcinoma. In addition, there are many risk factors affecting the prognosis of patients with primary hepatocellular carcinoma. Clinically, such factors should be scientifically monitoring or intervened to better improve the prognosis of patients.

关 键 词：原发性肝癌 预后营养指数 临床病理特征 总生存率 

分 类 号：R735.7[医药卫生—肿瘤]