预后免疫营养指数与腹腔镜结肠癌患者预后的相关性分析  

Analysis on Correlation between Prognostic Immunenutritional Index with Prognosis of Patients with Colon Cancer after Laparoscopic Surgery

作　　者：刘伟[1] 王艳[2] 于洋 陈占峰[1] 庄加红 房绍馨 许崇祥 

机构地区：[1]日照市人民医院普外科,山东 日照 [2]日照市人民医院重症医学科,山东 日照

出　　处：《临床医学进展》2023年第8期12703-12711,共9页Advances in Clinical Medicine

摘　　要：目的:探究预后免疫营养指数(PINI)与腹腔镜下结肠癌切除患者临床病理特征的关系,及其对结肠癌患者预后的影响。方法:回顾性分析接受腹腔镜根治性切除术的210例结肠癌患者资料,采用Clavien-Dindo评分对术后并发症分级。计算患者术前PINI值,将患者分为低PINI组与高PINI组,采用χ2检验或Fisher确切概率法分析PINI与临床病理特征的关系;采用Kaplan-Meier曲线进行生存分析;应用单因素及多因素分析PINI对患者术后并发症(CD评分 ≥ 2级)及远期死亡率的影响。结果:两组患者在年龄、体重指数、CEA、T分期、淋巴结转移、肿瘤大小、住院时间、术后并发症(CD评分 ≥ 2级)均有显著差异(P < 0.05),logistic多因素回归分析得出,低PINI值(OR = 2.926, 95%CI: 1.919~3.521, P < 0.01)是影响患者术后并发症的独立危险因素;低PINI患者的5年总生存率明显低于高PNI患者(71.9% vs 84.3%, P < 0.05);采用Cox多因素生存分析提示,低PINI值(RR = 2.093, 95%CI: 2.560~8.171, P < 0.05)、T ≥ 3期(RR = 2.491, 95%CI: 1.181~5.255, P < 0.05)是患者5年生存率的独立预测因子。结论:对于腹腔镜根治性切除术的结肠癌患者,术前低PINI提示患者预后不良,PINI是影响患者预后的重要独立危险因素,有助于个性化治疗决策制定。Objective: To investigate the correlation between prognostic immunenutritional index and postop-erative outcomes in patients with colon cancer treated with laparoscopic surgery, and to evaluate its predictive value. Methods: The clinical data of 210 patients with colon cancer who underwent curative laparoscopic colectomy were analyzed retrospectively. Clavien-Dindo grading standard was used to evaluate postoperative complications. The patients were classifified into Low-PINI group and High-PINI group. The relationship between PINI and clinicopathological features was analyzed by χ2 test or Fisher’s exacttest;survival analysis was described by Kaplan-Meier curve;univariate and multivariate analysis were used to analyze the factors that might affect the complications (CD grade ≥ 2) and overall survival. Results: There were significant differences between the two groups in terms of age, body mass index, CEA, Clinical T status, lymph node metastasis, tumor size, hospital stay, postoperative complications (CD grade ≥ 2) (P < 0.05). The logistic regression analysis showed that Low-PINI value (OR = 2.926, 95%CI: 1.919~3.521, P < 0.01) was independent risk factors for postoperative complications. The 5-year overall survival rate of Low-PINI patients was significantly lower than those of High-PINI patients (71.9% vs 84.3%, P < 0.05). The Cox regression analysis showed that low PINI (RR = 2.093, 95%CI: 2.560~8.171, P < 0.05) and Clinical T status (T ≥ 3) (RR = 2.491, 95%CI: 1.181~5.255, P < 0.05) were independent risk factors for overall survival rate. Con-clusion: For patients with colon cancer treated with laparoscopic surgery, preoperative low PINI in-dicates poor prognosis, and PINI is an important independent risk factor affecting patient prognosis, which helps to make personalized treatment decisions.

关 键 词：预后免疫营养指数 腹腔镜 结肠癌 预后 

分 类 号：R73[医药卫生—肿瘤]