预后营养指数对宫颈癌放疗患者预后的预测价值

Predictive value of prognostic nutritional index on prognosis of patients with cervical cancer radiotherapy

目的探讨预后营养指数(PNI)对宫颈癌患者放疗预后的预测价值。方法选取82例宫颈癌患者,根据患者入院后血常规及血生化检查结果计算PNI,放疗前及放疗结束后1个月内评估近期疗效,将完全缓解(CR)+部分缓解(PR)患者作为有效组,疾病稳定(SD)+疾病进展(PD)患者作为无效组,比较两组患者的PNI。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估PNI对宫颈癌患者生存情况的预测价值。根据PNI在ROC曲线上的cut-off值将82例宫颈癌患者分为高值组和低值组,比较两组患者的临床特征和3年总生存率。结果放疗结束后1个月疗效评估结果显示,82例宫颈癌患者中,CR 55例,PR 16例,SD 6例,PD 5例,有效组患者的PIN为(53.24±2.35),明显高于无效组患者的(46.81±2.44),差异有统计学意义(P﹤0.01)。PNI评估宫颈癌患者生存情况的AUC为0.696(95%CI:0.577~0.815),且cut-off值为48.82时约登指数最大,为0.378,此时灵敏度为63.41%、特异度为74.36%。根据PNI在ROC曲线上cut-off值(48.82)将82例宫颈癌患者分为高值组(PNI﹥48.82,n=39)和低值组(PNI≤48.82,n=43)。高值组和低值组宫颈癌患者临床分期、淋巴结转移情况比较,差异均有统计学意义(P﹤0.05)。高值组患者的3年总生存率为90.70%,高于低值组患者的74.36%,差异有统计学意义(P﹤0.05)。结论PNI对宫颈癌放疗患者的预后有一定预测价值,或可作为预后评估的指标辅助临床治疗。

Objective To investigate the predictive value of prognostic nutritional index(PNI)for the prognosis of cervical cancer patients undergoing radiotherapy.Method A total of 82 patients with cervical cancer were selected,and PNI was calculated according to the results of blood routine and blood biochemical examinations after admission.The short-term efficacy was evaluated before radiotherapy and within 1 month after the end of radiotherapy,and then complete response(CR)+partial response(PR)patients were regarded as the effective group,and patients with stable disease(SD)+progression disease(PD)were regarded as the ineffective group,the PNI of the two groups were compared.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the predictive value of PNI for patient survival.All cervical cancer patients were divided into high-value group and lowvalue group according to the cut-off value of PNI on the ROC curve,and the clinical characteristics and 3-year overall survival of the two groups were compared.Result The results of efficacy evaluation 1 month after radiotherapy showed that among the 82 cervical cancer patients,55 were CR,16 were PR,6 were SD,and 5 were PD.The PIN of the patients in the effective group was(53.24±2.35),which was significantly higher than that of the patients in the ineffective group(46.81±2.44),and the difference was statistically significant(P<0.01).The AUC of PNI for evaluating the survival of cervical cancer patients was 0.696(95%CI:0.577-0.815),and the Youden index was the largest cut-off value at 48.82,which was 0.378,with sensitivity of 63.41%and specificity of 74.36%.According to the cut-off value of PNI on the ROC curve(48.82),82 patients with cervical cancer were divided into high value group(PNI>48.82,n=39)and low value group(PNI≤48.82,n=43).The clinical stage and lymph node metastasis of cervical cancer patients in the high-value group and the low-value group were significantly different(P<0.05).The 3-year overall survival rate of patients in the high value group was 90.70%,which was higher than 74.36% of the patients in the low value group,and the difference was statistically significant(P<0.05).Conclusion PNI has a certain predictive value for the prognosis of patients with cervical cancer radiotherapy,or can be used as a prognostic index to assist clinical treatment.