预后营养指数对老年宫颈癌术后化疗患者预后的影响  

Effects of prognostic nutritional index on prognosis of elderly patients with cervical cancer undergoing postoperative chemotherapy

作　　者：李银霞 秦云霞[1] 翁莉莉 李燕 Li Yinxia;Qin Yunxia;Weng Lili;Li Yan(Department of Gynecologic Oncology,Cancer Hospital of Nantong City,Nantong,Jiangsu,226001,P.R.China)

机构地区：[1]南通市肿瘤医院肿瘤妇科,江苏南通226001

出　　处：《老年医学与保健》2023年第1期72-76,共5页Geriatrics & Health Care

摘　　要：目的探讨预后营养指数(PNI)在老年宫颈癌术后化疗患者预后评估中的意义。方法回顾性纳入2016年3月—2019年3月行术后化疗的115例老年宫颈癌患者为研究对象。对所有患者进行随访,随访终点为全因死亡,计算患者总生存期(OS)。收集患者的临床、实验室检查、手术以及病理学资料。根据受试者工作特征曲线所确定的PNI最佳截断值将患者进行分组,通过组间比较筛选可能影响PNI的指标。采用单因素和多因素Cox回归明确影响患者OS的独立危险因素。结果中位随访时间37个月,共计69例(60.0%)患者达随访终点。同PNI>48组(n=49)相比,PNI≤48组(n=66)组织学类型为鳞癌比例更高、FIGO分期Ⅱ期和Ⅲ期比例更高,且分化程度为中低分化比例也更高(均P<0.05)。Kaplan-Meier曲线显示,PNI≤48组中位生存期显著短于PNI>48组(41个月vs 52个月,P<0.001)。多因素Cox回归分析结果提示,淋巴结转移、肿瘤直径>4 cm、FIGO分期高以及PNI≤48是患者OS的独立危险因素(均P<0.05)。结论PNI对老年宫颈癌术后化疗患者的预后可能具有一定的预测作用,值得临床关注。Objective To explore the significance of prognostic nutritional index(PNI)in the prognosis evaluation of elderly patients with cervical cancer undergoing postoperative chemotherapy.Methods 115 elderly patients with cervical cancer who underwent postoperative chemotherapy from March 2016 to March 2019 were retrospectively included as study subjects.All patients were followed up.The end point of follow-up was all-cause death,and the overall survival period(OS)of patients was calculated.Their clinical,laboratory,surgical and pathological data were collected.They were divided into groups according to the optimal cut-off value of PNI determined by the receiver-operating characteristic curve,and the indicators that might affect PNI were screened through inter-group comparison.Univariate and multivariate Cox regression were used to identify the independent risk factors affecting patients’OS.Results The median follow-up time was 37 months,and a total of 69 patients(60.0%)reached the end point of follow-up.Compared with the PNI>48 group(n=49),the PNI≤48 group(n=66)had a higher proportion of squamous cell carcinoma,a higher proportion of FIGO stage II and III,and a higher proportion of medium-low differentiation(all P<0.05).Kaplan-Meier curve showed that the median survival time of the PNI≤48 group was significantly shorter than that of the PNI>48 group(41 months vs 52 months,P<0.001).Multivariate Cox regression analysis showed that lymph node metastasis,tumor diameter>4 cm,higher FIGO stage,and PNI≤48 were independent risk factors for OS(all P<0.05).Conclusion PNI may have a certain predictive effect on the prognosis of elderly patients with cervical cancer undergoing chemotherapy after surgery,which is worthy of clinical attention.

关 键 词：老年 宫颈癌 化疗 预后营养指数 总生存期 

分 类 号：R737.33[医药卫生—肿瘤]