食管鳞癌患者预后营养指数与炎症反应标志物相关性分析  

The prognostic value of nutritional index in patients with esophageal cancer surgery and its correlation with systemic inflam⁃matory response markers

作　　者：缪艳[1] 殷鸿[1] 李姗姗 王芳[1] 高嘉婧 周红[1] 冷雪峰 韩泳涛[1] Miao Yan;Yin Hong;Li Shanshan;Wang Fang;Gao Jiajing;Zhou Hong;Leng Xuefeng;Han Yongtao(Division of Thoracic Surgery,Sichuan Cancer Hospital.Research Institute·Cancer Prevention and Treatment Center of Sichuan Province,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省肿瘤医院·研究所·四川省癌症防治中心胸外科,成都610041

出　　处：《肿瘤代谢与营养电子杂志》2021年第3期274-278,共5页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：四川省科技厅国际合作项目(2020YFH0169)。

摘　　要：目的探讨预后营养指数对食管鳞状细胞癌(简称鳞癌)手术治疗患者的预后意义及其与全身炎症反应标志物的相关性。方法回顾性分析2017年12月至2018年10月在四川省肿瘤医院接受食管癌根治手术治疗的食管鳞癌患者临床资料,计算患者预后营养指数(PNI)、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)等指标,通过Spearman分析PNI与全身炎症反应标志物的相关性,采用Kaplan-Meier生存曲线和Cox比例风险回归模型分析不同PNI水平对食管鳞癌手术治疗患者预后的影响。结果PNI与LMR呈正相关(R=0.514,P<0.001),与NLR(R=-0.401,P<0.001)和PLR(R=-0.591,P<0.001)呈负相关。单因素分析结果显示,年龄(P=0.13)、LMR(P=0.004)、NLR(P=0.018)、PNI(P=0.017)与患者总生存期显著相关,进一步多因素分析结果显示,年龄(OR=1.676,95%CI=1.056~2.661,P=0.028)与PNI(OR=0.589,95%CI=0.370~0.939,P=0.026)是总生存期的独立预后因素。PNI≥45.26及年龄<65岁预示食管癌根治术患者的预后较好。结论PNI是接受食管癌根治术的食管鳞癌患者生存结局的重要预测指标。Objective To investigate the prognostic significance of prognostic nutritional index in patients with esophageal squamous cell carcinoma(ESCC)surgery and its correlation with systemic inflammatory response markers.Methods A retrospective analysis of the clinical data of patients with esophageal squamous cell carcinoma who underwent radical esophageal cancer surgery at Sichuan Cancer Hospital from December 2017 to October 2018.And calculate the patient′s prognostic nutritional index(PNI),neutrophil⁃to⁃lymphocyte ratio(NLR),lymphocyte⁃to⁃monocyte ratio(LMR),platelet⁃to⁃lymphocyte ratio(PLR)and other indicators.Spearman was used to analyze the correlation between PNI and systemic inflammatory response markers,and Kaplan⁃Meier survival curve and Cox proportional hazard regression model were used to analyze the impact of different PNI levels on the prognosis of patients with esophageal squamous cell carcinoma surgery.Results PNI was positively correlated with LMR(R=0.514,P<0.001),and negatively correlated with NLR(R=-0.401,P<0.001)and PLR(R=-0.591,P<0.001).Univariate analysis showed that age(P=0.13),LMR(P=0.004),NLR(P=0.018),PNI(P=0.017)were significantly related to the patient′s OS.Further multivariate analysis showed that age(OR=1.676,95%CI=1.056-2.661,P=0.028)and PNI(OR=0.589,95%CI=0.370-0.939,P=0.026)are independent prognostic factors of OS.PNI≥45.26 and age<65 years old indicate a better prognosis for patients undergoing radical esophageal cancer surgery.Conclusion PNI is an important predictor of survival outcome for patients with esophageal squamous cell carcinoma undergoing radical resection of esophageal cancer.It has certain clinical value.

关 键 词：食管鳞癌 预后营养指数 炎症反应标志物 预后 

分 类 号：R735.1[医药卫生—肿瘤]