| 郭孟刚,周海宁,杨绪全.预后营养指数评估食管癌病人术后并发症及预后的临床价值[J].安徽医药,2021,25(5):898-902. |
| 预后营养指数评估食管癌病人术后并发症及预后的临床价值 |
| The clinical value of prognostic nutritional index in the evaluation of postoperative complications and prognosis of esophageal cancer patients |
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| DOI：10.3969/j.issn.1009-6469.2021.05.013 |
| 中文关键词: 食管肿瘤 营养评价 并发症 预后 |
| 英文关键词: Esophageal neoplasms Nutrition assessment Complications Prognosis |
| 基金项目:四川省医学会科研课题( S15078) |
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| 中文摘要: |
| 目的探讨预后营养指数(PNI)评估食管癌病人术后并发症及预后的临床价值。方法选取遂宁市中心医院 2010年 1月至 2014年 6月接受食管癌根治术的食管癌病人 136例，根据术前 1周内血常规和生化检查结果计算 PNI值。采用受试者工作特征曲线( ROC)计算 Youden指数，并得出 PNI的最佳截断值，根据最佳截断值将病人分为高 PNI组与低 PNI组。比较两组临床病理特征、术后并发症。采用 Kaplan-Meier法绘制生存曲线，以 Log-rank检验分析组间差异。采用 Cox比例风险模型分析影响食管癌病人预后的危险因素。结果最佳截断值为 45.38，79例病人 PNI≥45.38分为高 PNI组， 57例病人 PNI<45.38分为低 PNI组。两组在饮酒史、肿瘤长度、浸润深度、淋巴结转移、临床分期等方面比较，差异有统计学意义( P<0.05)。高 PNI组吻合口瘘、肺部感染等并发症低于低 PNI组( P<0.05)。全组病人中位生存期 48.9月， 5年生存率为 36.8%。高 PNI组中位生存期为 56.2个月， 5年生存率为 48.1%。低 PNI组中位生存期为 38.7个月， 5年生存率为 21.1%。高 PNI组病人总生存时间明显优于低 PNI组( P<0.001)。单因素分析结果显示，病人饮酒史、肿瘤浸润深度、淋巴结转移、临床分期、 PNI与病人预后显著相关( P<0.05)。多因素分析结果显示，淋巴结转移、临床分期、 PNI是影响病人预后的独立危险因素。结论 PNI临床上容易获取、计算简便，与食管癌病人术后并发症相关，是影响病人预后的独立危险因素，可用于评估食管癌病人的术后并发症及预后。 |
| 英文摘要: |
| Objective To investigate the clinical value of prognostic nutritional index in the evaluation of postoperative complicationsand prognosis of esophageal cancer patients.Methods The clinical data of 136 patients who underwent curative esophagectomy fromJanuary 2010 to June 2014 in Suining Central Hospital were selected. The PNI value was calculated according to the blood routine andbiochemical examination results within one week before operation. The Youden index was calculated by receiver operating characteristic curve, and the best cut-off value of PNI was obtained. The patients were divided into high PNI group and low PNI group according to the best cut-off value. The clinicopathological characteristics and postoperative complications of the two groups were analyzed and compared. Kaplan-Meier method was used to draw survival curve, and Log-rank test was used to analyze the differences between groups. Cox proportional risk model was used to analyze the risk factors influencing the prognosis of esophageal cancer patients.Results The best cut-off value was 45.38, 79 patients with PNI≥45.38 were divided into high PNI group and 57 patients with PNI<45.38 were divided into low PNIgroup. There were significant differences between the two groups in drinking history, tumor length, invasion depth, lymph node metastasisand clinical stage (P<0.05). The complications of anastomotic leakage and pulmonary infection in high PNI group were lower than those in low PNI group(P<0.05). The median survival time of the whole group was 48.9 months, and the fifth year survival rate was 36.8%. The median survival time of high PNI group was 56.2 months, and the fifth year survival rate was 48.1%. The median survival time of low PNIgroup was 38.7 months, and the fifth year survival rate was 21.1%. The overall survival time of patients in high PNI group is significantlybetter than that in low PNI group (P<0.001). The results of univariate analysis showed that drinking history, tumor invasion depth, lymphnode metastasis, clinical staging and PNI were significantly correlated with prognosis (P<0.05). The results of multivariate analysisshowed that lymph node metastasis, clinical staging and PNI were independent risk factors for prognosis.Conclusions PNI is clinicallyeasy to obtain and calculate. It is correlated with postoperative complications of esophageal cancer patients, is an independent risk factorinfluencing the prognosis of patients, and can be used to evaluate postoperative complications and prognosis of esophageal cancer patients. |
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