Effects of Onodera's prognostic nutrition index (PNI)on the survival of patients with gallbladder carcinoma
-
摘要:
目的 研究胆囊癌患者的预后危险因素,并分析小野寺预后营养指数(PNI)对患者生存的影响意义。 方法 回顾性分析2008年1月至2012年12月于中南大学肝胆肠外科研究中心诊治的63例胆囊癌患者的生存预后。通过Cox比例风险模型分析明确患者的独立预后因素,并分析PNI对患者预后的影响。 结果 单因素分析显示,淋巴结转移、PNI≤50、鳞癌、肝脏侵润及胆总管的侵犯为OS的危险因素,而多因素分析中发现只有淋巴结转移状态(HR=4.495,95%CI=2.380~8.488,P < 0.001)及PNI(HR= 0.195,95%CI=0.098~0.389,P < 0.001)仍对OS的影响差异有统计学意义。进一步分层分析发现,PNI在中青年组(年龄≤65岁)的患者中对预后的预测能力相较于在老年组中(年龄>65岁)更为显著(中青年组:P=0.011;老年组:P=0.078)。 结论 PNI对胆囊癌患者术后预后的影响差异具有统计学意义,PNI≤50的患者其预后显著差于PNI>50的患者,在中青年组患者(年龄≤65岁)中这种差别更为显著。PNI有潜能作为一个评价胆囊癌患者术后预后评估的新证据,有利于临床医生更全面地掌握患者的整体情况。 Abstract:Objective To retrospectively evaluate the prognostic risk factors of patients with gallbladder carcinoma and the effect of normal prognostic nutrition index (PNI) on the survival. Methods We retrospectively analyzed 63 patients with gallbladder carcinoma treated in our hospital between January 2008 and December 2012. The independent prognostic factors of the patients were calculated by the Cox proportional hazards model. The benefit of normal PNI status on the prognosis was further explored in the patients using survival analysis. Results Lymph node metastasis, PNI≤50, squamous carcinoma, liver invasion and choledoch invasion were the risk factors of overall survival (OS) in the univariate analysis, while only lymph node metastasis (HR=4.495, 95%CI 2.380~8.488, P < 0.001) and PNI (HR=0.195, 95%CI 0.098~0.389, P < 0.001) were the dependent influential factors of the prognosis and OS in the multivariate analysis. The effect of PNI on OS was even more statistically significant different in the younger patients (≤65y) than in the elder (>65y) (younger group: P=0.011; elder group: P=0.078). Conclusion The gallbladder carcinoma patients with normal PNI status (> 50) have better OS compared to the patients with PNI≤50, with statistical differences between the two. And it is more significant in the patients of the younger group (≤65y), comparing with the elder group. PNI could be taken as a potential prognostic evaluation factor for the gallbladder carcinoma patients and can provide a more comprehensive evaluation of patients' conditions to clinician. -
Key words:
- gallbladder carcinoma /
- Onodera's prognostic nutrition index (PNI) /
- prognosis /
- age
-
表 1 全组患者的临床病理特征
Table 1. Clinicopathological characteristics of all tumor patients in the group
表 2 全组患者OS的单多因素分析
Table 2. Univariate and multivariate analyses of the prognostic factors by Cox' s regression model for overall survival(OS)in all patients of the group; p < 0.05, statistically significant
表 3 在不同年龄分组中各PNI亚组间OS对比
Table 3. Comparison of the effects of prognostic nutrition index on OS among various age groups
-
[1] Pinato DJ, North BV, Sharma R, et al. A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: The prognostic nutritional index[J]. Br J Cancer, 2012, 106 (8):1439-1445. doi: 10.1038/bjc.2012.92 [2] Benizri EI1, Bereder JM, Rahili A, et al. Ascites and malnutrition are predictive factors for incomplete cytoreductive surgery for peritoneal carcinomatosis from gastric cancer[J]. Am J Surg, 2013, 205 (6):668-673. doi: 10.1016/j.amjsurg.2012.06.009 [3] Hubbard TJ, Lawson-McLean A, Fearon KC, et al. Nutritional predictors of postoperative outcome in pancreatic cancer[J]. Br J Surg, 2011, 98(7):1032. [4] Wakita M, Fukatsu A, Amagai T. Nutrition assessment as a predictor of clinical outcomes for infants with cardiac surgery: using the prognostic nutritional index[J]. Nutr Clin Pract, 2011, 26(2): 192-198. doi: 10.1177/0884533611399922 [5] Taner CB, Nagorney DM, Donohue JH. Surgical treatment of gallbladder cancer[J]. J Gastrointest Surg, 2004, 8(1):83-89. doi: 10.1016/j.gassur.2003.09.022 [6] Jensen EH, Abraham A, Jarosek S, et al. Lymph node evaluation is associated with improved survival after surgery for early stage gallbladder cancer[J]. Surgery, 2009, 146(4):706-711. doi: 10.1016/j.surg.2009.06.056 [7] Meng H, Wang X, Fong Y. Outcomes of radical surgery for gallbladder cancer patients with lymphatic metastases[J]. Jpn J Clin Oncol, 2011, 41(8):992-998. doi: 10.1093/jjco/hyr072 [8] Higuchi R, Ota T, Araida T, et al. A 40-Year Single-Institution Study of Prognostic Factors and Resectability[J]. Ann Surg Oncol, 2014, 21(3):4308-4316. [9] 文骝, 刘会春.69例胆囊癌治疗效果分析[J].中华全科医学, 2012, 10(7):1044-1047. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=syqkyx201207022Wen L, Liu HC. Analysis of treatment effect of 69 gallbladder carcinoma cases[J]. Chinese Journal of General Practice, 2012, 10(7): 1044-1047. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=syqkyx201207022 [10] Nozoe T, Kohno M, Iguchi T, et al. The prognostic nutritional index can be a prognostic indicator in colorectal carcinoma[J]. Surgery Today, 2012, 42(6):532-535. doi: 10.1007/s00595-011-0061-0 [11] Yao ZH, Tian GY, Wan YY, et al. Prognostic nutritional index predicts outcomes of malignant pleural mesothelioma[J]. J Cancer Res Clin Oncol, 2013, 139(12):2117-2123. doi: 10.1007/s00432-013-1523-0 [12] Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature[J]. Nutr J, 2010, 9:69. doi: 10.1186/1475-2891-9-69 [13] Migita K, Takayama T, Saeki K, et al. The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage[J]. Ann Surg Oncol, 2013, 20(8):2647-2654. doi: 10.1245/s10434-013-2926-5 [14] Ray-Coquard I, Cropet C, Van Glabbeke M, et al. Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas[J]. Cancer Res, 2009, 69(13):5383-5391. doi: 10.1158/0008-5472.CAN-08-3845 [15] Yu TN, Shen B, Meng N, et al. Risk factors of lymphatic metastasis complement poor radiological detection in gallbladder cancer[J]. World J Gastroenterol, 2014, 20(1):290-295. doi: 10.3748/wjg.v20.i1.290
计量
- 文章访问数: 44
- HTML全文浏览量: 7
- PDF下载量: 0
- 被引次数: 0