预后营养指数和改良格拉斯哥预后评分与宫颈癌患者预后的关系

Correlations of prognostic nutritional index and modified Glasgow prognostic score with prognosis in patients with cervical cancer

目的探讨预后营养指数(PNI)和改良格拉斯哥预后评分(mGPS)对宫颈癌患者预后的预测价值。方法选取宫颈癌患者120例为研究对象。收集、分析患者完整资料,并随访至2023年6月30日。采用Kaplan-Meier法绘制生存曲线。采用Log-rank检验和Cox回归分析筛选预后的影响因素。结果本研究患者中位随访时间61个月,中位生存时间52个月,随访期内死亡41例(34.17%),患者3年和5年生存率分别为82.50%和66.67%。受试者工作特征(ROC)曲线显示,PNI、mGPS、白蛋白(ALB)、淋巴细胞(LYM)、C反应蛋白(CRP)和中性粒细胞(NEU)预测患者预后的曲线下面积(AUC)分别为0.90、0.81、0.84、0.86、0.82和0.71,最佳截断值分别为41.80、0.50分、34.25 g/L、1.44×10^(9)/L、5.45×10^(9)/L和7.25 mg/L。Cox回归分析显示,PNI(HR=4.18,95%CI:2.83~9.21,P=0.015)、mGPS[HR=1.95,95%CI:1.37~3.59,P<0.001(mGPS=1分);HR=3.07,95%CI:2.38~5.36,P<0.001(mGPS=2分)]和国际妇产科联盟(FIGO)分期[HR=2.03,95%CI:1.34~3.85,P=0.030(FIGO分期=Ⅲ期);HR=3.46,95%CI:2.15~6.62,P=0.003(FIGO分期=Ⅳ期)]是影响宫颈癌患者预后的危险因素。结论PNI、mGPS和FIGO分期是宫颈癌患者预后的重要预测因子,关注患者治疗前PNI和mGPS有利于改善其临床结局。

Objective To investigate the prognostic value of prognostic nutritional index(PNI)and modified Glasgow prognostic score(mGPS)in patients with cervical cancer.Methods A total of 120 patients with cervical cancer were selected as the study subjects.Patients′data were collected and analyzed,with follow-up conducted until June 30,2023.Kaplan-Meier method was used to plot survival curves.Log-rank test and Cox regression analysis were employed to identify prognostic factors.Results The median follow-up time for patients in this study was 61 months,with a median survival time of 52 months.During the follow-up period,41 patients(34.17%)died.The 3-year and 5-year survival rates were 82.50%and 66.67%,respectively.Receiver operating characteristic(ROC)curves showed that the areas under the curve(AUC)for PNI,mGPS,albumin(ALB),lymphocytes(LYM),C-reactive protein(CRP),and neutrophils(NEU)in predicting patient prognosis were 0.90,0.81,0.84,0.86,0.82,and 0.71,respectively.The optimal cutoff values were determined to be 41.80 for PNI,0.50 points for mGPS,34.25 g/L for ALB,1.44×10^(9)/L for LYM,5.45×10^(9)/L for CRP and 7.25 mg/L for NEU.Cox regression analysis indicated that PNI(HR=4.18,95%CI=2.83 to 9.21,P=0.015),mGPS[HR=1.95,95%CI=1.37 to 3.59,P<0.001(mGPS=1 point);HR=3.07,95%CI=2.38 to 5.36,P<0.001(mGPS=2 points)]and International Federation of Gynecology and Obstetrics(FIGO)staging[HR=2.03,95%CI=1.34 to 3.85,P=0.030(FIGO stage=stageⅢ);HR=3.46,95%CI=2.15 to 6.62,P=0.003(FIGO stage=stageⅣ)]were significant risk factors affecting the prognosis of cervical cancer patients.Conclusion PNI,mGPS and FIGO staging are important predictors of prognosis in cervical cancer patients.Attention to PNI and mGPS before treatment may help improve clinical outcomes.