术前预后营养指数对前列腺根治性切除术患者的生存预测价值

Predictive value of the pre-operative prognostic nutrition index for the survival of patients undergoing radical prostatectomy

目的探究术前预后营养指数(prognostic nutritional index,PNI)能否有效地用于评价前列腺癌根治性切除术患者的预后。方法回顾性分析2014年1月-2015年1月在蚌埠医学院第一附属医院首诊并行前列腺癌根治性切除术的156例患者的相关资料。根据行根治手术当次入院首次采血检查结果,确定前列腺癌患者临床资料和随访资料,分别计算患者PNI、中性粒细胞与淋巴细胞计数比值(neutrophil to lymphocyte ratio,NLR)和淋巴与单核细胞计数比值(lymphocyte to monocyte ratio,LMR)。利用受试者工作特征曲线(receiver operating characteristic curve,ROC)的特点,截取曲线上的最佳Cut-off值。对患者的总体生存采用Kaplan-Meier生存曲线进行分析,根治术患者预后相关因素的关联性通过Cox比例风险模型进行分析。结果患者术前PNI为49.58±6.69,最佳截断值为50.77,低PNI组(<50.77,81例)患者的生存风险明显高于高PNI组(≥50.77,75例)。PNI可能是前列腺癌根治术5年总体生存的独立影响因素。结论术前前列腺癌患者的PNI是根治术后生存的独立影响因素,有一定评估行根治手术的前列腺癌患者预后的临床应用价值。

Objective To explore whether or not the prognostic nutrition index(PNI)can be used to evaluate the prognosis of patients undergoing the radical resection of prostate cancer.Methods Retrospective analysis was performed on 156 patients who underwent radical resection of prostate cancer in the First Affiliated Hospital of Bengbu Medical College from January 2014 to January 2015.Clinical data and follow-up data of patients with prostate cancer were determined on the basis of the results of the first blood examination at the time of radical surgery.Pre-operative PNI,neutrophil-to-lymphocyte ratio and lymphatic-to-monocyte ratio were calculated.On the basis of the characteristics of receiver operating characteristic curve,the optimal cut-off value on the curve was intercepted.The overall survival(OS)of patients was analysed by Kaplan-Meier survival curve,and the association between the prognosis of patients undergoing radical surgery and pre-operative PNI was analysed by Cox proportional risk model.Results The pre-operative PNI of patients was 49.58±6.69,the best cut-off value was 50.77.The high PNI group(≥50.77,75 patients)had a significantly higher 5-year OS rate than the low PNI group(<50.77,81 patients).PNI was an independent risk element for 5-year OS after the radical resection of prostate cancer.Conclusion Pre-operative PNI is an independent risk factor affecting the survival of patients with prostate cancer after radical surgery,and it has a certain clinical application value to evaluate the prognosis of patients with prostate cancer undergoing radical surgery.