术前预后营养指数对肝细胞癌患者经动脉化疗栓塞术术后结局的预测价值  

Predictive value of preoperative prognostic nutritional index on postoperative outcome after transarterial chemoembolization in hepatocellular carcinoma patients

作　　者：李刚[1] 易根发[1] 赵卫[1] 王俊超 段正新 LI Gang;YI Genfa;ZHAO Wei;WANG Junchao;DUAN Zhengxin(Department of Interventional,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院介入科,云南昆明650032

出　　处：《实用放射学杂志》2025年第1期114-118,共5页Journal of Practical Radiology

摘　　要：目的探讨术前预后营养指数(PNI)对接受经动脉化疗栓塞术(TACE)的肝细胞癌(HCC)患者术后结局的预测价值。方法回顾性收集142例以TACE作为初始治疗的HCC患者的临床资料,根据受试者工作特征(ROC)曲线确定的截断值将术前全身免疫炎症指数(SII)、PNI、天门冬氨酸氨基转移酶-中性粒细胞比值(ANRI)、天门冬氨酸氨基转移酶-淋巴细胞比值(ALRI)、天门冬氨酸氨基转移酶-血小板比值(APRI)分为高、低2组,分析其对患者TACE后结局的影响。结果术前PNI与TACE后1周肝功能呈负相关;术前PNI、肿瘤大小是总生存期(OS)的独立危险因素,且PNI≥42.35组优于PNI<42.35组(OS 28个月vs 10个月),肿瘤大小<5 cm优于肿瘤大小≥5 cm(OS 37个月vs 11个月),差异均有统计学意义(P<0.05);而术前PNI是无进展生存期(PFS)的独立危险因素,PNI≥42.35组优于PNI<42.35组(PFS 6个月vs 3个月),差异有统计学意义(P<0.05)。结论术前PNI对HCC患者预后具有一定的预测价值,PNI<42.35组的HCC患者TACE后OS及PFS均较短。Objective To explore the predictive value of preoperative prognostic nutritional index(PNI)for postoperative outcomes of patients with hepatocellular carcinoma(HCC)undergoing transarterial chemoembolization(TACE).Methods The clinical datas of 142 HCC patients treated with TACE as initial treatment were retrospectively collected.According to the cut-off value determined by the receiver operating characteristic(ROC)curve,the preoperative systemic immune-inflammation index(SII),PNI,aspartate aminotransferase-neutrophil ratio(ANRI),aspartate aminotransferase-lymphocyte ratio(ALRI)and aspartate aminotransferaseplatelet ratio(APRI)were divided into high group and low group,and their effects of TACE on postoperative outcome were analyzed.Results Preoperative PNI was negatively correlated with liver function 1 week after TACE.Preoperative PNI and tumor size were independent risk factors for overall survival(OS).The PNI≥42.35 group was better than PNI<42.35 group(OS 28 months vs 10 months),the tumor size<5 cm was better than tumor size≥5 cm(OS 37 months vs 11 months),and the differences were statistically significant(P<0.05).PNI was an independent risk factor for progression-free survival(PFS).The PNI≥42.35 group was better than PNI<42.35 group(PFS 6 months vs 3 months),and the difference was statistically significant(P<0.05).Conclusion Preoperative PNI has a certain prognostic value in HCC patients,and the OS and PFS of HCC patients with PNI<42.35 group after TACE are shorter.

关 键 词：肝细胞癌 经动脉化疗栓塞术 炎症指标 预后 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学] R730.7