| 赵彦,祝淑钗,宋春洋,吴佩纹,许金蕊,王旋,闫可,李曙光,沈文斌.放疗前预后营养指数对临床Ⅲ期食管癌患者生存的影响分析[J].中华放射医学与防护杂志,2021,41(6):426-430 |
| 放疗前预后营养指数对临床Ⅲ期食管癌患者生存的影响分析 |
| Prognostic impact of prognostic nutritional index before radiotherapy in clinical stage Ⅲ esophageal cancer patients |
| 投稿时间：2021-01-09 |
| DOI：10.3760/cma.j.issn.0254-5098.2021.06.005 |
| 中文关键词: 食管鳞癌 预后营养指数 放射治疗 预后 |
| 英文关键词:Esophageal cancer Prognostic nutritional index (PNI) Radiotherapy Prognosis |
| 基金项目: |
|
| 摘要点击次数: 2116 |
| 全文下载次数: 923 |
| 中文摘要: |
| 目的 分析放疗前预后营养指数（PNI）对临床Ⅲ期食管癌患者生存预后的影响。方法 回顾性分析2013年至2017年河北医科大学第四医院125例临床Ⅲ期接受根治性放疗的食管癌患者，计算PNI、营养风险指数（NRI）等营养指标，采用受试者工作特征曲线（ROC）确定PNI最佳临界值为49.925，依此预后营养指数将患者分为低PNI组（PNI<49.925）和高PNI组（PNI≥49.925），NRI以100作为临界值分为NRI≥100和NRI<100，采用Kaplan-Meier法计算总生存（OS）和无进展生存（PFS）并行单因素生存分析，Cox回归模型对OS和PFS进行多因素生存分析。结果 放疗前PNI与血红蛋白（HGB）（r=0.505，P<0.001）和NRI （r=0.594，P<0.001）呈正相关。低PNI组和高PNI组患者1、3、5年OS分别为67.5%、27.3%、11.4%和85.4%、45.8%、27.4%，两组比较差异有统计学意义（χ2=8.569，P<0.05），低PNI组和高PNI组患者1、3、5年PFS分别为59.7%、23.2%、4.9%和79.2%、35.4%、24.9%，两组比较差异有统计学意义（χ2=6.715，P<0.05）。单因素分析显示，大体肿瘤体积（GTV）、放疗剂量、化疗、白蛋白（ALB）、NRI和PNI水平与总生存（χ2=6.822、4.326、4.474、13.123、8.846、8.569，P<0.05）和无进展生存相关（χ2=7.869、4.636、5.874、10.911、8.544、6.715，P<0.05）。多因素分析显示，GTV、放疗剂量、PNI是患者OS的独立影响因素（P<0.05），GTV、放疗剂量、是否化疗、PNI是患者PFS的独立影响因素（P<0.05）。结论 放疗前PNI是接受根治性放疗的临床Ⅲ期食管癌患者预后影响因素，可作为有效的预后指标。 |
| 英文摘要: |
| Objective To study the prognostic impact of prognostic nutritional index (PNI) before radiotherapy in clinical stage Ⅲ esophageal cancer patients. Methods We retrospectively reviewed 125 esophageal cancer patients with clinical stage Ⅲ undergoing definitive radiotherapy in Fourth Hospital of Hebei Medical University from 2013 to 2017. The PNI and nutritional risk index (NRI) were calculated before radiotherapy. The optimal cutoff value of PNI was determined by time-dependent receiver operating characteristics (ROC) at 49.925.The patients were divided into low PNI group(PNI<49.925) and high PNI group (PNI≥49.925).Based on NRI, the patients were divided into normal NRI group (NRI≥100) and abnormal NRI group (NRI<100). Kaplan-Meier method was used to calculate the overall survival (OS) and progression-free survival (PFS) and to perform univariate analysis. The mutlivariate analysis was performed by Cox regression model. Results PNI was positively correlated with hemoglobin (r=0.505,P<0.001) and NRI (r=0.594,P<0.001). The 1-, 3- and 5-year OS rates in the low PNI group were significantly lower than those of the high PNI group (67.5%, 27.3%, 11.4% vs. 85.4%, 45.8%, 27.4%, respectively, χ2=8.569, P<0.05). Moreover, the 1-, 3- and 5-year PFS rates in the low PNI group were obviously higher than those in the high PNI group (59.7%, 23.2%, 4.9% vs. 79.2%, 35.4%, 24.9%, respectively, χ2=6.715,P<0.05). Univariate analysis showed that GTV, radiotherapy dose, chemotherapy, albumin, NRI and PNI were significantly correlated with OS and PFS (OS:χ2=6.822,4.326, 4.474, 13.123, 8.846, 8.569, P<0.05: PFS:χ2=7.869, 4.636, 5.874, 10.911, 8.544, 6.715,P<0.05). Multivariate analysis showed that GTV, radiotherapy dose and PNI were independent prognostic factors for OS (P<0.05). And GTV, radiotherapy dose, chemotherapy and PNI were independent prognostic factors for PFS (P<0.05). Conclusions The PNI before radiotherapy is a significant and independent predictor for survival of clinical stage Ⅲ esophageal cancer patients. Based on simple and inexpensive standard laboratory measurements, PNI could be a promising prognostic biomarker for esophageal cancer patients. |
| HTML 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|