中国肺癌杂志2024，Vol.27Issue(12)：931-939,9.DOI:10.3779/j.issn.1009-3419.2024.106.33
预后营养指数在晚期NSCLC伴恶性胸腔积液患者预后和胸膜自发固定中的预测价值
Predictive Value of Prognostic Nutritional Index in Prognosis and Spontaneous Pleurodesis of Patients with Advanced Non-small Cell Lung Cancer and Malignant Pleural Effusion
摘要
Abstract
Background and objective A prognostic nutritional index(PNI)developed by nutritional status and inflammation are closely associated with poor prognosis in malignant tumors.However,the predictive impact of PNI in patients with malignant pleural effusion(MPE)remains inconclusive.The study aimed to determine the predictive value of PNI in prognosis and spontaneous pleurodesis among patients with MPE.Methods The patients diagnosed with advanced non-small cell lung cancer(NSCLC)with MPE in West China Hospital between January 2015 and December 2022 were reviewed and allocated randomly to development set(60%)and validation set(40%).After collecting clinical data,peripheral blood inflamma-tion indices and calculating systemic inflammation indices,the effects of PNI on prognosis and spontaneous pleurodesis have been evaluated by Cox proportional hazards models,Kaplan-Meier method and Nelson-Aalen cumulative risk curve.Results In total,261 patients diagnosed NSCLC with MPE were selected(development set:n=157;validation set:n=104),of whom 58.2%were aged<65 years,53.6%were male and 95.8%were diagnosed with adenocarcinoma.The dichotomous cut-offvalue for PNI was 44.1,respectively.Compared with lower PNI(PNI<44.1)cases,patients with higher PNI(PNI≥44.1)showed significantly longer overall survival(36.5 vs 24.3 mon,P=0.02)and higher incidence of spontaneous pleurodesis(P=0.009).According to the multivariate Cox analysis,higher PNI was associated with good prognosis and successful spontaneous pleurodesis(P<0.05).According to the results of Cox regression analysis,the PNI-prognosis and PNI-spontaneous pleurodesis models are determined,the receiver operating characteristic(ROC)curves are drawn,and the area under the curves(AUC)value of development set are 0.694(95%CI:0.620-0.776)and 0.673(95%CI:0.590-0.737).Conclusion PNI is a reliable biomarker of prognosis and spontaneous pleurodesis in patients with MPE.Attention to the patient's nutritional status and inflammation may improve the prognosis and efficacy of pleural effusion.关键词
肺肿瘤/恶性胸腔积液/预后营养指数/预后/胸膜自发固定Key words
Lung neoplasms/Malignant pleural effusion/Prognostic nutritional index/Prognosis/Spontaneous pleurodesis引用本文复制引用
谈思含,李为民,田攀文..预后营养指数在晚期NSCLC伴恶性胸腔积液患者预后和胸膜自发固定中的预测价值[J].中国肺癌杂志,2024,27(12):931-939,9.基金项目
本研究受国家自然科学基金项目(No.82473213、No.92159302)资助 This study was supported by the grants from National Natural Science Foundation of China(No.82473213,to Panwen TIAN （No.82473213、No.92159302）
No.92159302,to Weimin LI). （）
