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预后营养指数对结直肠癌同时性肝转移患者预后评估的价值
Prognostic value of prognostic nutritional index in colorectal cancer patients with simultaneous liver metastasis
【摘要】 目的探讨治疗前预后营养指数(PNI)与结直肠癌同时性肝转移患者预后的关系。方法回顾性分析2015年1月至2017年1月深圳市人民医院初诊初治的结直肠癌同时性肝转移患者83例临床资料,记录患者5年随访生存结局,利用ROC曲线选取约登指数最大值时的PNI值为截断值,分为高PNI组和低PNI组。采用Kaplan-Meier法进行生存分析,Cox比例风险模型筛选影响患者预后的因素。结果 83例中位随访时间13(9~25)个月,44例死亡。ROC曲线选取PNI值为50.4,约登指数为1.31,分为低PNI组44例(PNI<50.4,53.01%),高PNI组39例(PNI≥50.4,46.99%)。低PNI组的OS、PFS较高PNI组明显缩短(P=0.005、0.018)。PNI<50.4、未行根治手术、肝多发转移、年龄≥60岁是OS的独立预后不良因素,PNI<50.4、未行根治手术是PFS独立预后不良因素(均P<0.05)。结论治疗前PNI是结直肠癌同时性肝转移患者OS和PFS的独立预测因子。
【Abstract】 Objective To investigate the relationship between preoperative prognostic nutritional index (PNI) and prognosis of colorectal cancer (CRC) patients with simultaneous liver metastasis.Methods This retrospective cohort study included 83 patients of newly diagnosed CRC with simultaneous liver metastasis in Shenzhen People’s Hospital from January 2015 to January 2017.According to 5-year follow-up survival outcomes,the receiver operating characteristic curve (ROC) was used to determine the cut-off value of PNI,and the patients were divided into high PNI group and low PNI group.Kaplan-Meier method was used to analyze the related factors and survival.Cox proportional hazards model was used to screen the prognostic factors.Results The median follow-up time was 13 months (9 to 25 months),and 44 cases died.The Youden index was 1.31 and the PNI value was 50.4.According to PNI,44 cases (53.01%) were divided into low PNI group and 39 cases (46.99%) into high PNI group.The overall survival (OS) and progression free survival (PFS) of low PNI group were significantly shorter than those of high PNI group (P=0.005,0.018,respectively).PNI<50.4,without radical operation,multiple liver metastase,and age≥60 years old were independent prognostic factors of OS.PNI<50.4 and without radical operation were independent prognostic factors of PFS (both P<0.05).Conclusion Preoperative PNI is an independent predictor of OS and PFS in CRC patients with simultaneous liver metastasis.
【Key words】 Colorectal neoplasms; Liver metastasis; Prognostic nutritional index; Prognosis;
- 【文献出处】 中华普通外科学文献(电子版) ,Chinese Archives of General Surgery(Electronic Edition) , 编辑部邮箱 ,2021年04期
- 【分类号】R735.34
- 【被引频次】1
- 【下载频次】137