预后营养指数预测转移性胰腺癌一线化疗疗效及预后

Prognostic nutritional index predicts prognosis and efficacy of first-line chemotherapy for metastatic pancreatic cancer

目的探讨了预后营养指数(PNI)对转移性胰腺癌患者预后及一线化疗疗效的预测价值。方法回顾性分析2017年4月至2022年2月武汉大学中南医院肿瘤放化疗科接受一线化疗的83例转移性胰腺癌患者的临床资料及随访资料,计算PNI值;根据受试者操作特征曲线(ROC曲线)确定PNI预测转移性胰腺癌患者总生存(OS)的最佳截止点;根据最佳截止点将患者分为低PNI组(34例)与高PNI组(49例);采用Cox比例风险回归模型及Kaplan-Meier曲线研究PNI对于转移性胰腺癌患者生存的预测价值。结果根据ROC曲线,确定PNI最佳截止点为43.10。PNI与转移性胰腺癌患者一线化疗的客观缓解率、无进展生存时间(mPFS)及OS显著相关。全组患者的mPFS和中位总生存时间(mOS)分别为4.61(95%CI=3.92~5.30)和9.05(95%CI=8.20~9.89)个月。低PNI组与高PNI组的转移性胰腺癌患者一线化疗客观缓解率分别为5.9%和32.7%(P<0.05)。低PNI组与高PNI组的患者mPFS分别为2.96个月(95%CI=2.53~3.47)与5.67个月(95%CI=4.43~6.21),两组间具有显著差异(P<0.01)。同时,低PNI组与高PNI组的患者mOS分别为5.92个月(95%CI=5.30~6.55)与11.84个月(95%CI=9.10~14.59),两组间同样具有显著差异(P<0.01)。多因素Cox回归分析结果显示,PNI(HR=0.123,95%CI=0.061~0.248,P<0.01)是转移性胰腺癌患者OS的独立预后因素。结论PNI可作为转移性胰腺癌患者一线化疗疗效和生存的预后因素。

Objective We aim to investigate the clinical value of prognostic nutritional index(PNI)in evaluating the prognosis of patients with metastatic pancreatic cancer.Method Clinical data and follow-up data of 83 patients with metastatic pancreatic cancer undergoing first-line chemotherapy from April 2017 to February 2022 in Zhongnan Hospital of Wuhan University were retrospectively collected and analyzed.PNI value was calculated and the optimal cut-off point of PNI was determined using the receiver operation characteristics(ROC)curve.Cox univariate and multivariate regression analysis and Kaplan-Meier curve were performed to evaluate the prognostic value of PNI for metastatic pancreatic cancer patients.Result According to the ROC curve analysis,the optimal cut-off point of PNI was 43.10.PNI was significantly correlated with objective response rate(ORR),progression free survival(PFS)and overall survival(OS)of patients with metastatic pancreatic cancer receiving first-line chemotherapy.The median PFS and median OS were 4.61(95%CI=3.92-5.30)and 9.05(95%CI=8.20-9.89)months,respectively.The ORR in low PNI group and high PNI group was 5.9%and 32.7%respectively(P<0.05).The median progression free survival time(mPFS)of patients in low PNI group and high PNI group were 2.96 months(95%CI=2.53-3.47)and 5.67 months(95%CI=4.43-6.21),respectively.There was a significant difference between the two groups(P<0.01).Meanwhile,the median overall survival time(mOS)of patients in the low PNI group and the high PNI group was 5.92 months(95%CI=5.30-6.55)and 11.84 months(95%CI=9.10-14.59),respectively.There was also a significant difference between the two groups(P<0.O1).Multivariate Cox regression analysis showed that PNI(HR=0.123,95%CI=0.061-0.248,P<0.01)was an independent prognostic factor of OS in patients with metastatic pancreatic cancer.Conclusion PNI can be used as a prognostic factor for patients with metastatic pancreatic cancer.