预后营养指数对非小细胞肺癌化疗患者的预后价值研究

Prognostic value of prognostic nutritional index in patients with non small cell lung cancer

目的探讨预后营养指数（PNI）对非小细胞肺癌化疗患者的预后价值。方法采用回顾性分析的方法，选择本院2010年11月至2014年1月收治的非小细胞肺癌患者179例，所有患者均经病理学证实组织类型为非小细胞肺癌。收集患者的临床资料，计算每位患者的PNI值，根据所有患者的PNI四分位数将患者分为4组，PNIQ0-25组、PNIQ25-50组、PNIQ50-75组、PNIQ75-100组。采用Kaplan—Meier法绘制生存曲线，Log-rank法比较各组无进展生存期（DFS）及总生存期（OS）的差异。结果（1）PNIQ0-25组、PNIQ25-50组、PNIQ50-75组、PNIQ75-100组比较，年龄、是否吸烟、KPS评分差异有统计学意义（P〈0．05）。（2）PNIQ0-25组中位总生存期为11．5个月（95％CI：6．6—15．4），3年生存率为6．7％；PNIQ225-50组中位总生存期为12．2个月（95％CI：9．1—18．0），3年生存率为6．4％；PNIQ50-75组中位总生存期为14．1个月（95％CI：8．7—13．3），3年生存率为11．4％，PNIQ75-100组中位总生存期为15．0个月（95％CI：12．3～17．8），3年生存率为11．6％。经Log—rank法检验，四组患者的总生存率差异有统计学意义（X^2=15．6，P=0．001）。（3）PNIQ。硒组中位无进展生存期为5．0个月（95％CI：4．3～5．6），3年无进展生存率为4．4％；PNIQ25-50组中位无进展生存期为6．4个月（95％CI：4．7～8．1），3年无进展生存率为4．3％；PNIQ50-75组中位无进展生存期为7．4个月（95％CI：6．0～8．7），3年无进展生存率为9．1％，PNIQ75-100组中位无进展生存期为8．9个月（95％CI：6．4～10．8），3年无进展生存率为9．3％。经Log-rank法检验，四组患者的无进展生存率差异有统计学意义（X^2=26．7，P=0．000）。结论PNI对非小细胞肺癌化疗患者的预后有良好的应用价值。

Objective To investigate the prognostic value of prognostic nutritional index （PNI） in patients with non-small cell lung cancer. Methods A total of 179 patients with non small cell lung cancer was enrolled in our hospital from November 2010 to January 2014. All patients were pathologically confirmed to be non small cell lung cancer. The clinical data of patients were collected, and the PNI values of each patient were calculated. The patients were divided into 4 groups according to the patients in the PNI of the patients in the treatment group （PNIQ0-25 group, PNIQ25-50 group, PNIQ50-75 group and PNIQ75-100 group）. The survival curve was drawn by Kaplan-Meier method, and the difference of progression free sur- vival （DFS） and overall survival （OS） of each group was compared by Log-rank method. Results （1） compared with PNIQ0-25 group, PNIQ25-50 group, PNIQ50-75 group and PNIQ75-100 group, there was significant difference in age, smoking and KPS score （ P 〈 0. 05 ）. （2） the PNIQ0-25 group had a median overall survival of 11.5 months （95% CI： 6. 6 - 15.4）, the 3 year survival rate was 6. 7% ; PNIQ25-50 group had a median overall survival of 12. 2 months （ 95% CI： 9. 1 -18 ） , the 3 year survival rate was 6. 4% in PNIQ50-75 group; the median overall survival was 14. 1 the month of （95% CI： 8.7-13.3）, the 3 year survival rate was 11.4% , the PNIQ75_I0o group had a median overall survival of 15 months （95% CI： 12. 3 17.8）, the 3 year survival rate was 11.6%. The Log-rank test, the four groups of patients with a signi-ficant difference in overall survival （X^2 = 15.6, P=0. 001 ）. （3） the PNIQ0-25 group had a median progression free survival was 5 months for （95% CI： 4. 3-5. 6）, the 3 year progression free survival rate was 4.4% ; PNIQ25-50 group had a median progression free survival was 6.4 months for （95% CI： 4. 7-8.1 ） , the 3 year progression free survival rate was 4. 3% in the PNIQ50-75 group; the median progression free sur-vival was 7.4 months （95% CI： 6-8.7）, the 3 year progression free survival rate was 9. 1% in PNIQ75_10o group, the median progression free survival was 8. 9 months for （95% CI： 6. 4 - 10. 8）, the 3 year progression free survival rate was 9. 3% by Log-rank test, survival was statistically significant was no difference between the fonr groups （X^2= 26. 7 ,P = 0. 000）. Conclusions PNI has a good application value in the prognosis of patients with non-small cell lung cancer.