术前老年人营养风险指数对胰腺导管腺癌预后的预测价值

The prognostic value of preoperative geriatric nutritional risk index for patients with pancreatic ductal adenocarcinoma

目的评估术前老年人营养风险指数(geriatric nutritional risk index,GNRI)是否可以作为胰十二指肠切除术后胰腺导管腺癌(pancreatic ductal adenocarcinoma,PDAC)患者预后的评价指标。方法回顾性分析2006年1月1日至2015年12月31日在温州医科大学附属第一医院行胰十二指肠切除术的265例PDAC患者。对患者临床及随访资料进行统计学分析,评估GNRI对PDAC患者预后判断价值。结果在265例患者中,95例(35.8%)被归为异常GNRI组(GNRI≤98),170例(64.2%)被归为正常GNRI组(GNRI>98)。多因素Cox回归分析显示GNRI(P=0.009)、年龄(P=0.003)、饮酒史(P=0.015)、肿瘤分级(P=0.007)、TNM分期(P<0.001)和CA19-9水平(P=0.004)与总体生存率(overall survival,OS)存在显著关联。结论对于接受了胰十二指肠切除术的PDAC患者,其术前GNRI可能是一个有用的预后预测指标。

Objective To assess if preoperative geriatric nutritional risk index(GNRI) could be a prognostic factor for patients with pancreatic ductal adenocarcinoma(PDAC) who underwent pancreaticoduodenectomy.Methods A total of 265 consecutive patients with PDAC who received pancreaticoduodenectomy between Jan.2006 and Dec. 2012 were included in this study. The Cox regression analysis was performed to calculate the overall survival(OS) and to assess the prognostic factors. Results Of the 265 patients, 95(35.8%) and 170(64.2%)were classified into abnormal group(GNRI ≤ 98) and normal GNRI group(GNRI>98),respectively. Multivariate Cox analysis showed that GNRI(P=0.009), age(P=0.003), drinking history(P=0.015), tumor grade(P=0.007),TNM stage(P<0.001) and CA19-9 level(P=0.004) were significantly associated with overall survival. Conclusion GNRI can be a useful prognostic indicator for patients with PDAC who underwent pancreaticoduodenectomy.