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术前预后营养指数对前列腺根治性切除术患者的生存预测价值

梁玉杰 张永琪 陈梦杰 关翰 李文永 刘贝贝 刘建民

梁玉杰, 张永琪, 陈梦杰, 关翰, 李文永, 刘贝贝, 刘建民. 术前预后营养指数对前列腺根治性切除术患者的生存预测价值[J]. 中华全科医学, 2022, 20(2): 224-227. doi: 10.16766/j.cnki.issn.1674-4152.002318
引用本文: 梁玉杰, 张永琪, 陈梦杰, 关翰, 李文永, 刘贝贝, 刘建民. 术前预后营养指数对前列腺根治性切除术患者的生存预测价值[J]. 中华全科医学, 2022, 20(2): 224-227. doi: 10.16766/j.cnki.issn.1674-4152.002318
LIANG Yu-jie, ZHANG Yong-qi, CHEN Meng-jie, GUAN Han, LI Wen-yong, LIU Bei-bei, LIU Jian-min. Predictive value of the pre-operative prognostic nutrition index for the survival of patients undergoing radical prostatectomy[J]. Chinese Journal of General Practice, 2022, 20(2): 224-227. doi: 10.16766/j.cnki.issn.1674-4152.002318
Citation: LIANG Yu-jie, ZHANG Yong-qi, CHEN Meng-jie, GUAN Han, LI Wen-yong, LIU Bei-bei, LIU Jian-min. Predictive value of the pre-operative prognostic nutrition index for the survival of patients undergoing radical prostatectomy[J]. Chinese Journal of General Practice, 2022, 20(2): 224-227. doi: 10.16766/j.cnki.issn.1674-4152.002318

术前预后营养指数对前列腺根治性切除术患者的生存预测价值

doi: 10.16766/j.cnki.issn.1674-4152.002318
基金项目: 

安徽省自然科学基金项目 2008085QH358

蚌埠医学院自然科学重点项目 BYKY2019035ZD

详细信息
    通讯作者:

    刘建民,E-mail: LIU-john-jm@sina.com

  • 中图分类号: R737.25 R730.7

Predictive value of the pre-operative prognostic nutrition index for the survival of patients undergoing radical prostatectomy

  • 摘要:   目的  探究术前预后营养指数(prognostic nutritional index,PNI)能否有效地用于评价前列腺癌根治性切除术患者的预后。  方法  回顾性分析2014年1月—2015年1月在蚌埠医学院第一附属医院首诊并行前列腺癌根治性切除术的156例患者的相关资料。根据行根治手术当次入院首次采血检查结果,确定前列腺癌患者临床资料和随访资料,分别计算患者PNI、中性粒细胞与淋巴细胞计数比值(neutrophil to lymphocyte ratio,NLR)和淋巴与单核细胞计数比值(lymphocyte to monocyte ratio,LMR)。利用受试者工作特征曲线(receiver operating characteristic curve, ROC)的特点,截取曲线上的最佳Cut-off值。对患者的总体生存采用Kaplan-Meier生存曲线进行分析,根治术患者预后相关因素的关联性通过Cox比例风险模型进行分析。  结果  患者术前PNI为49.58±6.69,最佳截断值为50.77,低PNI组(<50.77,81例)患者的生存风险明显高于高PNI组(≥50.77,75例)。PNI可能是前列腺癌根治术5年总体生存的独立影响因素。  结论  术前前列腺癌患者的PNI是根治术后生存的独立影响因素,有一定评估行根治手术的前列腺癌患者预后的临床应用价值。

     

  • 图  1  预后营养指数(PNI)、淋巴细胞-单核细胞比(LMR)、中性粒细胞-淋巴细胞比(NLR)的ROC曲线

    图  2  高PNI组与低PNI组前列腺癌根治术后生存的Kaplan-Meier曲线

    表  1  PNI、NLR和LMR的ROC曲线结果

    项目 AUC Cut-off 灵敏度(%) 特异度(%) P 95%CI
    PNI 0.742 50.770 0.575 0.833 <0.001 0.660~0.825
    NLR 0.631 3.386 0.842 0.417 0.017 0.523~0.739
    LMR 0.615 4.040 0.692 0.556 0.037 0.503~0.727
    下载: 导出CSV

    表  2  影响前列腺根治术后生存的COX单因素分析

    项目 B SE Wald χ2 P HR 95%CI
    年龄 0.023 0.031 0.551 0.458 1.023 0.963~1.086
    T分期 0.863 0.411 4.411 0.036 2.370 1.059~5.304
    N分期 1.219 0.434 7.879 0.005 3.383 1.444~7.922
    AJCC预后分期 1.106 0.562 3.881 0.049 3.023 1.006~9.089
    PSA 0.008 0.007 1.474 0.225 1.008 0.995~1.021
    Gleason评分 0.291 0.449 0.421 0.516 1.338 0.555~3.224
    NLR -0.244 0.090 7.378 0.007 0.784 0.657~0.934
    LMR -0.098 0.088 1.244 0.265 0.907 0.763~1.077
    PNI -0.168 0.037 20.504 <0.001 0.845 0.786~0.909
    下载: 导出CSV

    表  3  影响前列腺根治术后生存的COX多因素分析

    项目 B SE Wald χ2 P HR 95%CI
    T分期 0.990 0.396 6.250 0.012 2.691 1.238~5.848
    N分期 1.302 0.416 9.822 0.002 3.677 1.629~8.303
    AJCC预后分期 1.254 0.521 5.801 0.016 3.505 1.263~9.724
    NLR -0.249 0.087 8.081 0.004 0.780 0.657~0.926
    PNI -0.197 0.035 31.930 <0.001 0.821 0.767~0.879
    下载: 导出CSV
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出版历程
  • 收稿日期:  2021-07-23
  • 网络出版日期:  2022-03-04

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