预后营养指数与食管鳞癌放疗疗效及预后的相关性  

Association of prognostic nutritional index with response to radiotherapy and clinical outcomes of patients with esophageal squamous cell carcinoma

作　　者：张建国[1] 陆颖芝[1] 邵艳[1] 杨云云[1] 黄关宏[1] 马兆明[1] Zhang Jianguo;Lu Yingzhi;Shao Yan;Yang Yunyun;Huang Guanhong;Ma Zhaoming(Department of Esophageal Oncology,Lianyungang Second People's Hospital(Lianyungang Tumor Hospital),Lianyungang 222000,China)

机构地区：[1]连云港市第二人民医院连云港市肿瘤医院食管肿瘤科,222023

出　　处：《国际医药卫生导报》2021年第1期29-34,共6页International Medicine and Health Guidance News

基　　金：南京医科大学康达学院科研发展基金2018(KD2018KYJJYB055);连云港市第二人民医院中青年人才成长基金(TQ201905)。

摘　　要：目的探讨放疗前预后营养指数(prognostic nutritional index,PNI)与食管鳞癌(esophageal squamous cell carcinoma,ESCC)放疗近期疗效及预后的关系。方法回顾分析2015年1月至2017年12月于本院的152例不宜手术或拒绝手术而接受根治性放疗的食管鳞癌患者的临床资料。采用ROC曲线及Youden指数确定PNI的最佳临界值。用Kaplan-Meier法绘制生存曲线,采用Cox回归模型分析影响食管鳞癌放疗患者的独立预后因素。结果PNI最佳临界值为48.9,曲线下面积0.717,敏感度为89.1%,特异度为72.6%。PNI与ESCC患者的病灶长度、T分期、临床分期、有无淋巴结转移密切相关。单因素分析显示,肿瘤长度、临床分期、PNI与ESCC患者的预后有关;多因素回归分析显示,PNI为影响ESCC患者预后的独立因素。结论PNI是一种无创、经济及便捷的全身炎性反应指标,在食管鳞癌患者放疗疗效预测及预后判断中有重要价值。Objective To evaluate the association of prognostic nutritional index(PNI)with response to radiotherapy and prognostic outcome in patients with esophageal squamous cell carcinoma(ESCC).Methods The clinical data of 152 patients with non-operated esophageal squamous cell carcinoma who underwent definitive radiotherapy from January,2015 to December,2017 at our hospital were retrospectively analyzed.The receiver operating characteristic(ROC)curve and Youden index were used to determine the cut-off value of PNI.Their survival curves were described by Kaplan-Meier method and compared by Log-rank test.Univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors.Results When the PNI was 48.9,the area under the ROC curve was 0.717,with a sensitivity of 89.1%and a specificity of 72.6%.PNI was associated with lesion length,T stage,clinical stage,and lymph node metastasis.Univariate analysis demonstrated that tumor length,clinical stage,and PNI were related to the patients'prognosis.Multivariate analysis showed that PNI was an independent factor in predicting the overall survival rate.Conclusion PNI may qualify as a noninvasive,cost-effective,and convenient prognostic indicator for patients with ESCC undergoing radiotherapy.

关 键 词：预后营养指数 食管鳞癌 放射治疗 预后 

分 类 号：R735.1[医药卫生—肿瘤]