术前预后营养指数在脑胶质瘤患者术后预后评估中的应用

目的:探讨术前预后营养指数(prognostic nutrition index,PNI)在脑胶质瘤患者术后临床预后中的应用。方法:收集2011年1月至2017年6月四川省大邑县人民医院神经外科手术治疗且经术后病理确诊的131例初发脑胶质瘤患者的临床资料及术后生存资料，采用ROC曲线分析获得PNI的最佳临界值，依据该最佳临界值将患者分为高PNI值组及低PNI值组，采用卡方检验比较两组临床病理学特征，采用Cox比例风险回归模型分析PNI与胶质瘤患者术后临床预后的关系。结果:131例脑胶质瘤患者术后中位总生存时间（overall survival，OS）为23个月，95%CI:9.736~36.264个月，术后1年、2年、3年、5年生存率分别为76.3%、52.0%、43.0%、33.5%。ROC曲线分析，PNI的最佳临界值为48.5。低PNI值组中年龄≥45岁、行非全切手术和较低级别肿瘤分级所占的比例较高PNI值组更高(P＜0.05)。多因素Cox回归分析显示，肿瘤分级、PNI值是影响脑胶质瘤患者术后预后的独立影响因素。结论:PNI值为脑胶质瘤患者预后的独立危险因素，较低的PNI水平预示着较差的预后。PNI值可用于初步判断脑胶质瘤患者的预后。

The application of preoperative prognostic nutrition index in predicting outcomes of patients with glioma

Objective:To investigate the prognostic values of preoperative prognostic nutrition index (PNI) in patients with glioma.Methods:In the study,the clinical data and postoperative survival data of 131 patients with pathological diagnosis of glioma were enrolled which were confirmed in department of neurosurgery,Dayi County People's Hospital from January 2011 to June 2017.The best critical value of PNI was obtained by ROC curve analysis.According to the best critical value,patients were divided into high PNI group and low PNI group.Chi square test was used to compare the clinicopathological characteristics of the two groups.Cox proportional risk regression model was used to analyze the relationship between PNI and clinical prognosis of glioma patients.Results:The median postoperative overall survival (OS) of 131 patients with glioma was 23 months,95%CI:9.736~36.264 months.The 1-,2-,3-,and 5-year survival rates were 76.3%,52.0%,43.0%,and 33.5%,respectively.According to ROC curve analysis,the best critical value of PNI was 48.5.In the low PNI group,the proportion of age ≥ 45 years old,the proportion of non-total resection and lower grade tumor classification was higher than that in the high PNI group (P＜0.05).Multivariate Cox regression analysis showed that tumor grade and PNI were independent factors influencing the prognosis of patients with glioma.Conclusion:PNI is an independent risk factor for the prognosis of patients with glioma.Low PNI level indicates poor prognosis.PNI value can be used to judge the prognosis of patients with glioma.