术前预后营养指数在高龄大肠癌患者预后中的临床价值

目的:明确高龄大肠癌患者术前预后营养指数(PNI)与远期预后的相关性。方法:回顾性分析盘锦市中心医院普通外科2010年1月—2014年10月收治的154例高龄(>80岁)大肠癌患者的临床资料。依据受试者工作特征曲线(ROC)确定PNI最佳临界值为45.3,以此分为低PNI组(≤45.3,n=71)和高PNI组(>45.3,n=83),比较两组患者临床病理特征,采用Cox回归模型进行单因素和多因素分析术后5年无复发生存因素和总生存因素。结果:术前低PNI与肿瘤TNM分期(P=0.010)、术前NLR(P=0.008)、PLR(P<0.001)及CONUT评分(P<0.001)有关。本研究的中位随访时间为32(13~88)个月,术后并发症(P=0.019)和术前低PNI(P=0.030)是无复发生存的独立危险因素;术前低PNI是远期预后的独立危险因素(P=0.028)。结论:高龄大肠癌患者术前低PNI与预后不佳存在显著相关性,围手术期营养支持可能对延长生存期有重要意义。

Clinical value of preoperative prognostic nutritional index in elderly patients with colorectal cancer

Objective:The correlation between preoperative nutritional index(PNI)and long-term prognosis was to determine in elderly patients with colorectal cancer.Methods:The clinical data of 154 elderly patients(>80 years)who underwent surgery for colorectal cancer in Panjin Central Hospital from January 2010 to October 2014 were retrospectively analyzed.The optimal critical value of PNI was determined to be 45.3 based on the receiver operating characteristic curve,which was divided into the low PNI group(≤45.3,n=71)and the high PNI group(>45.3,n=83).The chi-square test and t test were used to compare the clinicopathological features of the two groups,and Cox regression model were used to analyze the factors of relapse-free survival and overall survival in 5 years after surgery.Results:Preoperative low PNI was associated with TNM stage(P=0.010),NLR(P=0.008),PLR(P<0.001)and CONUT score(P<0.001).The median follow-up period was 32(13-88)months.Postoperative complications(P=0.019)and low preoperative PNI(P=0.030)were independent risk factors for relapse-free survival.Low preoperative PNI was an independent risk factor for long-term prognosis(P=0.028).Conclusion:There was a significant correlation between low preoperative PNI and poor prognosis in elderly patients with colorectal cancer.