预后营养指数对食管癌术后放疗患者预后的影响研究  

The effect of prognostic nutritional index in patients with esophageal carcinoma

作　　者：刘申香 毛海燕[1] 王洁 袁昕 LIU Shenxiang;MAO Haiyan;WANG Jie;YUAN Xin(Affiliated Hospital of Yangzhou University,Yangzhou 225001,China)

机构地区：[1]扬州大学附属医院,225001

出　　处：《中国老年保健医学》2023年第3期48-52,共5页Chinese Journal of Geriatric Care

摘　　要：目的探究预后营养指数(PNI)与手术后接受辅助放疗的食管鳞状细胞癌(ESCC)患者的临床病理特点及预后的相关性。方法回顾性分析2015年6月1日至2017年6月1日扬州大学附属医院肿瘤科收治的93例术后病理确诊为食管鳞状细胞癌并行术后辅助放疗患者的临床资料。根据放疗前病情评估时所测白蛋白水平和淋巴细胞计数计算得到PNI,并根据受试者工作特征(ROC)曲线确定PNI最佳截断值,将纳入研究的所有患者分为H-PNI组和L-PNI组。分析PNI与一般临床病理特征及总生存时间的关系;通过单因素及多因素Cox回归分析,比较各项因素对食管癌术后辅助放疗患者预后的影响。结果PNI最佳截断值为47.275,将纳入研究的93例患者分为L-PNI组(PNI≤47.275,43例)和H-PNI组(PNI>47.275,50例)。方差分析显示两组患者在年龄分组、性别、吸烟史、饮酒史、同步化疗、肿瘤长度及术后病理N分期方面的差异没有统计学意义,但是在H-PNI组中病理T分期为T1~T2期的患者多于L-PNI组(P=0.044),H-PNI组中术后病理TNM分期Ⅰ~Ⅱ的患者多于L-PNI组(P=0.022)。Kaplan-Meier生存分析显示H-PNI组患者总生存时间优于L-PNI组(P<0.001)。单因素分析结果显示PNI水平、饮酒吸烟史、术后病理T分期、术后病理TNM分期及肿瘤病灶的长度与预后相关。多因素分析结果显示,PNI术后病理T分期、术后病理TNM分期和肿瘤病灶的长度是食管鳞状细胞癌患者接受术后辅助放射治疗的独立预后影响因素。结论PNI可以作为接受术后辅助放疗的食管鳞状细胞癌患者的预后指标,临床使用价格合理,易操作,值得临床广泛应用。Objective To explore the correlation between prognostic nutritional index(PNI)and clinicopathological features and prognosis of esophageal cancer patients who received adjuvant radiotherapy after operation.Methods The clinical data of 93 consecutive patients with esophageal squamous cell carcinoma diagnosed by postoperative pathology and assisted radiotherapy in the oncology department of the Affiliated Hospital of Yangzhou University from June 1,2015 to June 1,2017 were analyzed retrospectively.According to the albumin level and lymphocyte count measured before radiotherapy,the PNI value was calculated,and the best cut-off value of PNI was determined according to receiver operating characteristic curve(ROC).All patients included in the study were divided into H-PNI group and L-PNI group.Aim to analyze the relationship between PNI and general clinicopathological features and total survival time.Univariate and multivariate Cox regression analysis were used to compare the effects of various factors on the prognosis of esophageal cancer patients.Results According to the best cut-off value of PNI,93 patients were divided into L-PNI group(PNI≤47.275,n=43)and H-PNI group(PNI>47.275,n=50).The Chi-squared Test showed that there was no significant difference between two groups in age,sex,smoking history,drinking history,concurrent chemotherapy,tumor length and postoperative pathological N stage,but there were more patients with pathological T stage T1~T2 in H-PNI group than in L-PNI group(P=0.044),and more patients with postoperative pathological TNM stage I~II in H-PNI group than in L-PNI group(P=0.022).Kaplan-Meier survival analysis showed that the overall survival of patients in H-PNI group was better than that in L-PNI group(P<0.001).Univariate analysis showed that PNI level,drinking and smoking history,postoperative pathological T stage,postoperative pathological TNM stage and tumor length were related to prognosis.Multivariate analysis showed that PNI level,postoperative pathological T stage,postoperative patholog

关 键 词：食管癌 预后营养指数 放疗 预后 

分 类 号：R735.1[医药卫生—肿瘤]