中国耳鼻咽喉头颈外科2025，Vol.32Issue(3)：143-148,6.DOI:10.16066/j.1672-7002.2025.03.002
基于时间依赖的受试者工作特征曲线分析术前预后营养指数对下咽鳞状细胞癌患者的预后意义
Prognostic value of preoperative prognostic nutrition index in hypopharyngeal cancer patients based on time-dependent receiver operating characteristic curve
摘要
Abstract
OBJECTIVE To explore the prognostic significance of the prognostic nutrition index(PNI)in patients with hypopharyngeal cancer undergoing surgical treatment.METHODS Clinical and pathological data of 117 patients with hypopharyngeal carcinoma who underwent surgical treatment at the center of Otolaryngology Head and Neck Surgery of Beijing Friendship Hospital,Capital Medical University from May 2014 to June 2022 were collected.The prognostic significance of hematological indicators such as PNI and neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and systemic immune inflammation index(SⅡ)were investigated.The time-dependent receiver operating characteristic(tROC)curves were used to analyze the sensitivity and specificity of various hematological indicators and to determine their optimal cutoffvalues.The Kaplan-Meier method was used to plot the postoperative survival curve,and the Cox regression model was used to analyze the correlation between PNI and overall survival(OS)and disease-free survival(DFS).RESULTS 117 patients were enrolled in this cohort,of which 109 were clinically classified as advanced stage(Ⅲ-Ⅳ).63 cases underwent surgery to preserve laryngeal function.The 5-year OS is 46.07％.According to the analysis of the tROC curve,the optimal cutoffvalue for PNI is 46.75.PNI is correlated with tumor T staging,NLR,PLR,and SⅡ.Kaplan Meier univariate analysis showed that PNI was significantly correlated with OS and DFS(P<0.05).In addition,tumor N-stage,postoperative complications,adverse pathological prognostic factors,NLR,PLR,and SⅡ were all significantly correlated with OS(P<0.05).Tumor N-stage,laryngeal preservation,postoperative complications,NLR,and SⅡ were significantly correlated with DFS(P<0.05).The Cox multivariate analysis results indicated that PNI,tumor N-stage,and postoperative complications were independent factors affecting OS and DFS.CONCLUSION Preoperative PNI,tumor N-stage,and postoperative complications are independent risk factors for OS and DFS in patients with hypopharyngeal carcinoma.PNI,as a prognostic indicator for predicting hypopharyngeal cancer patients,is superior to other hematological indicators.关键词
下咽肿瘤/预后/预后营养指数Key words
Hypopharyngeal Neoplasms/Prognosis/prognostic nutrition index引用本文复制引用
苑黎娜,张奥博,李万鑫,路承,田俊,任舒灵,刘良发,董研博..基于时间依赖的受试者工作特征曲线分析术前预后营养指数对下咽鳞状细胞癌患者的预后意义[J].中国耳鼻咽喉头颈外科,2025,32(3):143-148,6.基金项目
国家自然科学基金青年项目(82303642) （82303642）
