PLR和PNI联合评分预测胃癌预后的评估价值

Value of PLR combined with PNI score in predicting the prognosis of gastric cancer

目的:评估基于术前血小板与淋巴细胞比值(PLR)和预后营养指数(PNI)建立的PLR-PNI评分对胃癌病人预后的评估价值。方法:回顾性分析171例行胃癌根治术病人的临床资料,通过受试者工作特征曲线(ROC)根据5年生存率确定PLR、PNI的最佳临界值。根据临界值分为高PLR组(PLR≥148,1分)和低PLR组(PLR<148,0分),高PNI组(PNI≥47,0分)和低PNI组(PNI<47,1分)。评估不同评分病人预后情况。结果:PLR-PNI=2的病人,5年总生存率低于PLR-PNI=1或0的病人(11.36%vs 32.79或63.64,P<0.05)。多因素分析显示,肿瘤分化差、TNM分期晚、PLR-PNI评分高是影响胃癌病人术后预后的独立危险因素(P<0.01)。结论:术前高PLR-PNI是预测胃癌不良预后的独立因素,该评分系统可应用于临床以识别高危病人。

Objective:To evaluate the value of platelet/lymphocyte ratio(PLR)-prognostic nutritional index(PNI)score based on preoperative PLR and PNI in predicting the prognosis of patients with gastric cancer.Methods:The clinical data of 171 patients undergoing radical gastrectomy for gastric cancer were analyzed retrospectively,and the optimal cut-off values of PLR and PNI were determined according to the 5-year survival rate through the receiver operating characteristic(ROC)curve.According to the cut-off value,they were divided into high PLR group(PLR≥148,1 point)and low PLR group(PLR<148,0 point),high PNI group(PNI≥47,0 point)and low PNI group(PNI<47,1 point).The prognosis of patients with different scores was evaluated.Results:The 5-year overall survival rate of patients with PLR-PNI value of 2 was lower than that of patients with PLR-PNI value of 1 or 0(11.36%vs 32.79 or 63.64,P<0.05).Multivariate analysis showed that poor tumor differentiation,late TNM staging,and high PLR-PNI score were independent risk factors for postoperative prognosis of patients with gastric cancer(P<0.01).Conclusions:Preoperative high PLR-PNI is an independent factor to predict the poor prognosis of gastric cancer.Thus,the scoring system can be used to differentiate high-risk patients in clinical work.