预后营养指数和HALP评分与中晚期前列腺癌病人预后的关系:一项多中心回顾性研究

Correlation between prognostic nutritional index and HALP score with the prognosis of middle-advanced prostate cancer patients:A multicenter retrospective study

目的:探讨预后营养指数(PNI)和HALP评分与中晚期前列腺癌病人预后的关系。方法:纳入2013年至2018年3所综合性三级医院收治的中晚期前列腺癌病人168例,回顾病人病历资料,随访总生存时间(OS)和无进展生存时间(PFS),采用受试者工作特征曲线(ROC)曲线计算PNI和HALP评分预测病人预后的曲线下面积(AUC)和最佳截断值,Kaplan-Meier法绘制生存曲线,Log-rank检验和Cox回归分析病人OS和PFS的影响因素。结果:随访时间55(38.5,63)个月,随访期内死亡87例(51.79%),中位总生存时间和中位无进展生存时间分别为50个月和45个月,3年OS和PFS生存率分别为72.02%和64.29%。PNI和HALP评分预测病人预后的ROC曲线下面积分别为0.912和0.828,最佳截断值分别为46.30和31.64(P<0.05)。多因素Cox回归显示:PNI<46.3、HALP评分<31.64和年龄≥60岁是病人OS的危险因素,其HR(95%CI)分别为6.016(3.273~11.056)、2.537(1.531~4.205)和1.776(1.221~2.967),P<0.05;AJCC分期Ⅳ期、PNI<46.30和HALP<31.64均是病人PFS的危险因素,HR(95%CI)分别为2.777(1.381~5.419)、5.940(3.245~10.872)和2.481(1.498~4.109),P<0.05。结论:PNI和HALP评分可预测中晚期前列腺癌病人预后。

Objective:To explore the relationship between the Prognostic Nutritional Index(PNI)and the HALP score with the prognosis of patients with middle-to-advanced prostate cancer.Methods:A total of 168 patients with middle-to-advanced prostate cancer admitted to three comprehensive tertiary hospitals were observed from 2013 to 2018.Patient medical records were reviewed,and overall survival(OS)and progression-free survival(PFS)were followed up.The receiver operating characteristic(ROC)curve was used to calculate the area under the curve(AUC)and the optimal cut-off value of PNI and HALP scores for predicting patients’prognosis.The Kaplan-Meier method was used to draw survival curves,and the Log-rank test and Cox regression were used to analyze the influencing factors of patient OS and PFS.Results:The follow-up period was 55(38.5,63)months,with 87 deaths(51.79%)during this period.The median OS and PFS times were 50 months and 45 months,respectively.The 3-year OS and PFS survival rates were 72.02%and 64.29%,respectively.The areas under the ROC curve for predicting patients’prognosis with PNI and HALP scores were 0.912 and 0.828,respectively,with optimal cut-off values of 46.3 and 31.64(P<0.05).Multivariate Cox regression showed that PNI<46.3,HALP score<31.64,and age≥60 years were risk factors for OS with HR(95%CI)of 6.016(3.273~11.056),2.537(1.531~4.205),and 1.776(1.221~2.967),respectively(P<0.05).AJCC stage IV,PNI<46.3,and HALP<31.64 were risk factors for PFS with HR(95%CI)of 2.777(1.381~5.419),5.940(3.245~10.872),and 2.481(1.498~4.109),respectively(P<0.05).Conclusion:PNI and HALP scores can predict the prognosis of patients with middle-to-advanced prostate cancer.