中国全科医学2016，Vol.19Issue(28)：3428-3433,6.DOI:10.3969/j.issn.1007-9572.2016.28.009
预后营养指数在食管腺癌患者预后评估中的价值研究
Investigation in Prognostic Value of Prognostic Nutritional Index in Patients with Esophageal Adenocarcinoma
摘要
Abstract
Objective To investigate the prognostic value of prognostic nutritional index in patients with esophageal adenocarcinoma. Methods 128 cases of esophageal adenocarcinoma treated in Fourth Hospital of Hebei Medical University between January 1st 2008 and December 31st 2010 were retrospectively analyzed. Demographic and clinicopathological data of patients were collected, including gender, age, degree of histological differentiation, tumour location and size, lymphatic metastasis,TNM classification, postoperative exhaust time, postoperative defecation time, diagnosis of stump invasion and tumour thrombus. The calculation of PNI was based on the count data of serum albumin and peripheral blood lymphocytes collected within one week before surgery. The date of surgery was set as starting point,and the date of death or the end date of follow-up ( December 31st 2015) as end point. The survival rate was calculated by Kaplan-Meier analysis;the differences between groups were compared using Log-rank test. Cox proportional hazard regression model was used to analyze the factors which may affect the prognosis of the patients. Results 120 out of 128 cases completed follow-up,so that the follow-up rate was 93. 8%. Patients were divided into high PNI group(n=41)and low PNI group(n=79)by the average value of PNI(40. 82). The tumour size,lymphatic metastasis, TNM classification and postoperative exhaust time of the patients were compared, and all the differences had statistical significance ( P﹤0. 001 ) . The results of single-factor analysis indicated that there were significant differences in the tumour size,lymphatic metastasis,TNM classification,postoperative exhaust time,postoperative defecation time and PNI(P﹤0. 05). The results of Cox proportional hazard regression model showed that TNM classification and PNI were the independent factors that affected the prognosis of the patients with esophageal adenocarcinoma(P﹤0. 05). The patients were divided into young &middle-aged group ( n=63 ) and senior group ( n =57 ) by the average age ( 61. 5 years old ) . The results of single -factor analysis indicated that in young & middle -aged group there were significant differences in gender, tumour size,lymphatic metastasis,TNM classification,postoperative exhaust time,postoperative defecation time and PNI( P﹤0. 05 );in senior group, there were significant differences in gender, tumour size, TNM classification, postoperative defecation time and PNI(P﹤0. 05). The results of Cox proportional hazard regression model showed that TNM classification, postoperative exhaust time and PNI were the independent factors that affected the prognosis of the young&middle-aged patients with esophageal adenocarcinoma(P﹤0. 05);PNI was the independent factor that affected the prognosis of the senior patients with esophageal adenocarcinoma(P﹤0. 05). Conclusion PNI is able to assess the surgical risk for patients with esophageal adenocarcinoma,and it is a valuable clinical marker of preoperative estimation as well as prognosis prediction.关键词
食管肿瘤/营养评价/预后Key words
Esophageal neoplasms/Nutrition assessment/Prognosis分类
医药卫生引用本文复制引用
王岩,陶仁海,曹玉,高峰,殷金环,张立敏,周军,刘俊峰..预后营养指数在食管腺癌患者预后评估中的价值研究[J].中国全科医学,2016,19(28):3428-3433,6.基金项目
河北省医学科学研究重点课题计划 （）
