BACKGROUND Gastric cancer is the third most common cause of cancer related death worldwide.Surgery with or without chemotherapy is the most common approach with curative intent;however,the prognosis is poor as mortali...BACKGROUND Gastric cancer is the third most common cause of cancer related death worldwide.Surgery with or without chemotherapy is the most common approach with curative intent;however,the prognosis is poor as mortality rates remain high.Several indexes have been proposed in the past few years in order to estimate the survival of patients undergoing gastrectomy.The preoperative nutritional status of gastric cancer patients has recently gained attention as a factor that could affect the postoperative course and various indexes have been developed.The aim of this systematic review was to assess the role of the prognostic nutritional index(PNI)in predicting the survival of patients with gastric or gastroesophageal adenocarcinoma who underwent gastrectomy with curative intent.AIM To investigate the role of PNI in predicting the survival of patients with gastric or gastroesophageal junction adenocarcinoma.METHODS A thorough literature search of PubMed and the Cochrane library was performed for studies comparing the overall survival(OS)of patients with gastric or gastroesophageal cancer after surgical resection depending on the preoperative PNI value.The PRISMA algorithm was used in the screening process and finally 16 studies were included in this systematic review.The review protocol was registered in the International Prospective Register of Systematic Reviews(PRO) RESULTS Sixteen studies involving 14551 patients with gastric or esophagogastric junction adenocarcinoma undergoing open or laparoscopic or robotic gastrectomy with or without adjuvant chemotherapy were included in this systematic review.The patients were divided into high-and low-PNI groups according to cut-off values that were set according to previous reports or by using receiver operating characteristic curve analysis in each individual study.The 5-year OS of patients in the low-PNI groups ranged between 39%and 70.6%,while in the high-PNI groups,it ranged between 54.9%and 95.8%.In most of the included studies,patients with high preoperative PNI showed statistically significant better OS than the low PNI groups.In multivariate analyses,low PNI was repeatedly recognised as an independent prognostic factor for poor survival.CONCLUSION According to the present study,low preoperative PNI seems to be an indicator of poor OS of patients undergoing gastrectomy for gastric or gastroesophageal cancer.展开更多
BACKGROUND The prognostic nutritional index(PNI),a marker of immune-nutrition balance,has predictive value for the survival and prognosis of patients with various cancers.AIM To explore the clinical significance of th...BACKGROUND The prognostic nutritional index(PNI),a marker of immune-nutrition balance,has predictive value for the survival and prognosis of patients with various cancers.AIM To explore the clinical significance of the preoperative PNI on the prognosis of ampullary adenocarcinoma(AC)patients who underwent curative pancreaticoduodenectomy.METHODS The data concerning 233 patients diagnosed with ACs were extracted and analyzed at our institution from January 1998 to December 2020.All patients were categorized into low and high PNI groups based on the cutoff value determined by receiver operating characteristic curve analysis.We compared disease-free survival(DFS)and overall survival(OS)between these groups and assessed prognostic factors through univariate and multivariate analyses.RESULTS The optimal cutoff value for the PNI was established at 45.3.Patients with a PNI≥45.3 were categorized into the PNI-high group,while those with a PNI<45.3 were assigned to the PNI-low group.Patients within the PNI-low group tended to be of advanced age and exhibited higher levels of aspartate transaminase and total bilirubin and a lower creatinine level than were those in the PNI-high group.The 5-year OS rates for patients with a PNI≥45.3 and a PNI<45.3 were 61.8%and 43.4%,respectively,while the 5-year DFS rates were 53.5%and 38.3%,respectively.Patients in the PNI-low group had shorter OS(P=0.006)and DFS(P=0.012).In addition,multivariate analysis revealed that the PNI,pathological T stage and pathological N stage were found to be independent prognostic factors for both OS and DFS.CONCLUSION The PNI is a straightforward and valuable marker for predicting long-term survival after pancreatoduodenectomy.The PNI should be incorporated into the standard assessment of patients with AC.展开更多
BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AI...BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.展开更多
BACKGROUND Remnant gastric cancer(GC)is defined as GC that occurs five years or more after gastrectomy.Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic ...BACKGROUND Remnant gastric cancer(GC)is defined as GC that occurs five years or more after gastrectomy.Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer(RGC)patients are crucial.A simple scoring system that combines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary.AIM To evaluate the value of preoperative immune-nutritional scoring systems in predicting the prognosis of patients with RGC.METHODS The clinical data of 54 patients with RGC were collected and analyzed retrospectively.Prognostic nutritional index(PNI),controlled nutritional status(CONUT),and Naples prognostic score(NPS)were calculated by preoperative blood indicators,including absolute lymphocyte count,lymphocyte to monocyte ratio,neutrophil to lymphocyte ratio,serum albumin,and serum total cholesterol.Patients with RGC were divided into groups according to the immune-nutritional risk.The relationship between the three preoperative immune-nutritional scores and clinical characteristics was analyzed.Cox regression and Kaplan–Meier analysis was performed to analyze the difference in overall survival(OS)rate between various immune-nutritional score groups.RESULTS The median age of this cohort was 70.5 years(ranging from 39 to 87 years).No significant correlation was found between most pathological features and immune-nutritional status(P>0.05).Patients with a PNI score<45,CONUT score or NPS score≥3 were considered to be at high immune-nutritional risk.The areas under the receiver operating characteristic curves of PNI,CONUT,and NPS systems for predicting postoperative survival were 0.611[95%confidence interval(CI):0.460–0.763;P=0.161],0.635(95%CI:0.485–0.784;P=0.090),and 0.707(95%CI:0.566–0.848;P=0.009),respectively.Cox regression analysis showed that the three immunenutritional scoring systems were significantly correlated with OS(PNI:P=0.002;CONUT:P=0.039;NPS:P<0.001).Survival analysis revealed a significant difference in OS between different immune-nutritional groups(PNI:75 mo vs 42 mo,P=0.001;CONUT:69 mo vs 48 mo,P=0.033;NPS:77 mo vs 40 mo,P<0.001).CONCLUSION These preoperative immune-nutritional scores are reliable multidimensional prognostic scoring systems for predicting the prognosis of patients with RGC,in which the NPS system has relatively effective predictive performance.展开更多
AIM: To investigate the impact of prognostic nutritional index (PNI) on the postoperative complications and long-term outcomes in gastric cancer patients undergoing total gastrectomy.
Objective： The predictive and prognostic role of prognostic nutritional index（PNI） in gastric cancer patients with peritoneal dissemination remains unclear. This study aims to explore the role of the PNI in predict...Objective： The predictive and prognostic role of prognostic nutritional index（PNI） in gastric cancer patients with peritoneal dissemination remains unclear. This study aims to explore the role of the PNI in predicting outcomes of gastric cancer patients with peritoneal dissemination.Methods： A total of 660 patients diagnosed with gastric adenocarcinoma with peritoneal metastasis between January 2000 and April 2014 at Sun Yat-sen University Cancer Center and the Sixth Affiliated Hospital of Sun Yatsen University were retrospectively analyzed. The clinicopathologic characteristics and clinical outcomes of patients with peritoneal dissemination were analyzed.Results： Compared with PNI-high group, PNI-low group was correlated with advanced age（P=0.036）, worse performance status（P0.001）, higher frequency of ascites（P0.001） and higher frequency of multisite distant metastasis（P0.001）. Kaplan-Meier survival curves showed that PNI-high group had a significantly longer median overall survival than PNI-low group（13.13 vs. 9.03 months, P0.001）. Multivariate survival analysis revealed that Borrmann type IV（P=0.014）, presence of ascites（P=0.017） and lower PNI（P=0.041） were independent poor prognostic factors, and palliative surgery（P0.001） and first-line chemotherapy（P0.001） were good prognostic factors. For patients receiving palliative surgery, the postoperative morbidity rates in the PNI-low group and PNIhigh group were 9.1% and 9.9%, respectively（P=0.797）. The postoperative mortality rate was not significantly different between PNI-low and PNI-high groups（2.3% vs. 0.9%, P=0.362）.Conclusions： PNI is a useful and practical tool for evaluating the nutritional status of gastric cancer patients with peritoneal dissemination, and is an independent prognostic factor for these patients.展开更多
AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric can...AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric cancer.METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate.Univariate and multivariate analyses were performed to identify risk factors for overall survival(OS). Propensity score analysis was performed to adjust variables to control for selection bias.RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring(hazard ratio, 1.668; 95% confidence interval:1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage Ⅱ-Ⅲ disease(P = 0.019, P < 0.001), T3-T4 tumors(P <0.001), or lymph node metastasis(P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS(P = 0.022, P = 0.030, P < 0.001, and P = 0.024,respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively.CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.展开更多
Background: The prognostic nutritional index(PNI) has been widely applied for predicting survival outcomes of patients with various malignant tumors. Although a low PNI predicts poor prognosis in patients with colorec...Background: The prognostic nutritional index(PNI) has been widely applied for predicting survival outcomes of patients with various malignant tumors. Although a low PNI predicts poor prognosis in patients with colorectal cancer after tumor resection, the prognostic value remains unknown in patients with stage Ⅲ colon cancer undergoing curative tumor resection followed by adjuvant chemotherapy. This study aimed to investigate the prognostic value of PNI in patients with stage III colon cancer.Methods: Medical records of 274 consecutive patients with stage Ⅲ colon cancer undergoing curative tumor resection followed by adjuvant chemotherapy with oxaliplatin and capecitabine between December 2007 and December2013 were reviewed. The optimal PNI cutoff value was determined using receiver operating characteristic(ROC) curve analysis. The associations of PNI with systemic inflammatory response markers, including lymphocyte-to-monocyte ratio(LMR), neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), and C-reactive protein(CRP)level, and clinicopathologic characteristics were assessed using the Chi square or Fisher's exact test. Correlation analysis was performed using Spearman's correlation coefficient. Disease-free survival(DFS) and overall survival(OS)stratified by PNI were analyzed using Kaplan-Meier method and log-rank test, and prognostic factors were identified by Cox regression analyses.Results: The preoperative PNI was positively correlated with LMR(r= 0.483, P < 0.001) and negatively correlated with NLR(r =-0.441, P < 0.001), PLR(r =-0.607, P < 0.001), and CRP level(r =-0.333, P < 0.001). A low PNI(≤49.22)was significantly associated with short OS and DFS in patients with stage ⅢC colon cancer but not in patients with stage ⅢA/ⅢB colon cancer.In addition, patients with a low PNI achieved a longer OS and DFS after being treated with6-8 cycles of adjuvant chemotherapy than did those with < 6 cycles. Multivariate analyses revealed that PNI was independently associated with DFS(hazard ratios 2.001; 95% confidence interval 1.157-3.462; P = 0.013).Conclusion: The present study identified preoperative PNI as a valuable predictor for survival outcomes in patients with stage Ⅲ colon cancer receiving curative tumor resection followed by adjuvant chemotherapy.展开更多
BACKGROUND Pancreaticoduodenectomy(PD) is a complex surgical procedure with a high morbidity rate. The serious complications are major risk factors for poor longterm surgical outcome. Studies have reported an associat...BACKGROUND Pancreaticoduodenectomy(PD) is a complex surgical procedure with a high morbidity rate. The serious complications are major risk factors for poor longterm surgical outcome. Studies have reported an association between early postoperative prognostic nutritional index(PNI) and prediction of severe complications after abdominal surgery. However, there have been no studies on the use of early postoperative PNI for predicting serious complications following PD.AIM To analyze the risk factors and early postoperative PNI for predicting severe complications following PD.METHODS We retrospectively analyzed 238 patients who underwent PD at our hospital between January 2007 and December 2017. The postoperative complications were classified according to the Dindo-Clavien classification. Grade Ⅲ-Ⅴ postoperative complications were classified as serious. The risk factors for serious complications were analyzed by univariate analysis and multivariate logistic regression analysis.RESULTS Overall complications were detected in 157 of 238 patients(65.9%) who underwent PD. The grade Ⅲ-Ⅴ complication rate was 26.47%(63/238 patients).The mortality rate was 3.7%(9/238 patients). Multivariate logistic regression analysis revealed that preoperative serum albumin [odds ratio(OR): 0.883, 95%confidence interval(CI): 0.80-0.96; P < 0.01] and PNI on postoperative day 3 <40.5(OR: 2.77, 95%CI: 1.21-6.38, P < 0.05) were independent factors associated with grade Ⅲ-Ⅴ postoperative complications.CONCLUSION Perioperative albumin is an important factor associated with serious complications following PD. Low early postoperative PNI(< 40.5) is a predictor for serious complications.展开更多
BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestina...BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.展开更多
Objective To compare the value and consistency among the Patient Generated-Subjective Global Assessment(PG-SGA)and the Prognostic Nutrition Index(PNI)for assessing nutritional status in gastrointestinal tumor patients...Objective To compare the value and consistency among the Patient Generated-Subjective Global Assessment(PG-SGA)and the Prognostic Nutrition Index(PNI)for assessing nutritional status in gastrointestinal tumor patients.Methods 251 patients from gastric cancer surgical ward from January 2019 to January 2020 were recruited through convenience sampling in this respective study.Nutritional screening and assessment were conducted for 251 gastrointestinal tumor patients using the nutritional risk screening 2002(NRS 2002)PG-SGA,and the PNI.PNI was calculated using the serum albumin level and the total lymphocyte count obtained from the patients’routine laboratory examination when they were admitted to the hospital.The receiver operating characteristic(ROC)of the PG SGA and the PNI were plotted with the NRS 2002 used as the gold standard,and the diagnostic value of the PG-SGA and PNI was reflected by the area under the curve(AUC),sensitivity,specificity and Youden index.We then determined the optimal cut-off for the PNI and tested the consistency of the PG-SGA and PNI.Results The optimal cut-off point for the PNI was calculated to be 50.78.The AUC of the PG-SGA was 0.908(95%CI 0.871-0.944).The sensitivity was 89.9%,specificity was 76.2%and the Youden index was 0.661.The AUC of the PNI was 0.594(95%CI 0.516-0.572).The sensitivity was 73.8%,specificity was 44.3%and the Youden index was 0.181.In the consistency test,the kappa value was 0.838(P<0.001).Conclusion The PNI is of limited value for assessing malnutrition,although it did have good consistency with the PG-SGA.The combination of the PNI and PG-SGA can be used for diagnosing assessing malnutrition in clinical practice.展开更多
In this editorial,I comment on the article by Li et al published in the recent issue of the World Journal of Gastrointestinal Surgery in 2023,investigating the role of some novel prognostic factors for early survival ...In this editorial,I comment on the article by Li et al published in the recent issue of the World Journal of Gastrointestinal Surgery in 2023,investigating the role of some novel prognostic factors for early survival after radical resection of liver cancer.Liver cancer is an important burden among Asian and Western popu-lations,despite recent advances in both medicine(from virus eradication to systemic target therapies)and surgery.However,survival after proven radical surgery remains poor,with recurrences being the rule.Many prognostic scores have been developed and validated to select those patients who will best benefit from radical liver surgery,although the final general and oncological outcomes continue to be highly jeopardized.Unfortunately,no single biomarker can resolve all these issues for hepatocellular carcinoma,and it remains to be proven whether some of them main-tain predictive power in the long-term follow-up.In the ongoing era of“preci-sion”medicine,the novel prognostic markers,including immune inflammatory and nutritional indexes could be of great help in better stratify surgical candi-dates.展开更多
This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer.Lu et al evaluated the ability of seven biomarkers t...This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer.Lu et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term outcomes.These biomarkers were albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,nutritional risk index,and geriatric nutritional risk index.The PNI was found to be a strong predictor of both overall and recurrence-free survival,underscoring its clinical relevance in managing patients with pancreatic cancer.展开更多
BACKGROUND The incidence of prostate cancer(PCa)is on the rise in China.The risk level of patients with PCa is associated with disease-free survival rate at 10 years after radical prostatectomy.Predicting prognosis in...BACKGROUND The incidence of prostate cancer(PCa)is on the rise in China.The risk level of patients with PCa is associated with disease-free survival rate at 10 years after radical prostatectomy.Predicting prognosis in advance according to the degree of risk can provide a reference for patients,especially treatment options and postoperative adjuvant treatment measures for high-risk/extremely high-risk patients.AIM To explore the predictive value of the prognostic nutritional index(PNI)for biological recurrence in Chinese patients with high/extremely high-risk PCa after radical prostatectomy.METHODS The biochemical test results and clinical data of 193 patients who underwent radical prostatectomy for the first time from January 2015 to December 2020 were retrospectively collected.The PNI value of peripheral blood within 1 wk before surgery was calculated,and during the follow-up period,prostate-specific antigen≥0.2 ng/mL was considered to have biological recurrence.The receiver operating characteristic(ROC)curve was used to calculate the optimal critical value and area under the curve(AUC)of the patients.According to the critical value,the progression-free survival of the high PNI group and low PNI group was compared.The independent influencing factors of the patients’prognosis were obtained by the Cox proportional hazards regression model.RESULTS The non-biological recurrence rates at 1,3,and 5 years were 92.02%,84.05%,and 74.85%,respectively.The optimal critical value for PNI to predict biological recurrence was 46.23,and the AUC was 0.789(95%confidence interval:0.651-0.860;P<0.001).The sensitivity and specificity were 82.93%and 62.30%,respectively.In accordance with the optimal critical value of the ROC curve(46.23),193 patients were further divided into a high PNI group(PNI≤46.23,n=108)and low PNI group(PNI>46.23,n=85).The incidence of postoperative complications in the high PNI group was lower than that in the low PNI group(21.18%vs 38.96%).Kaplan-Meier survival analysis showed that the overall survival rate at 5 years in the low PNI group was 87.96%(13/108),which was lower than that in the high PNI group(61.18%,33/85;P<0.05).Low PNI[hazard ratio(HR)=1.74;P=0.003]and positive incisal margin status(HR=2.14;P=0.001)were independent predictors of biological recurrence in patients with high/extremely high-risk PCa.CONCLUSION The PNI has predictive value for the prognosis of patients with high/extremely high-risk PCa,and is an independent prognostic factor.Patients with low PNI value have a shorter time of nonbiological recurrence after prostatectomy.It is expected that the combined prediction of other clinicopathological data will further improve the accuracy and guide postoperative adjuvant therapy to improve the quality of prognosis.展开更多
目的探讨格拉斯哥预后评分(GPS)和预后营养指数(PNI)对早期预测急性胰腺炎严重程度和预后的临床应用价值。方法回顾性收集聊城市第二人民医院2019年1月1日—2023年3月31日连续收治的280例急性胰腺炎患者的临床资料,包括患者一般临床资...目的探讨格拉斯哥预后评分(GPS)和预后营养指数(PNI)对早期预测急性胰腺炎严重程度和预后的临床应用价值。方法回顾性收集聊城市第二人民医院2019年1月1日—2023年3月31日连续收治的280例急性胰腺炎患者的临床资料,包括患者一般临床资料、实验室各项相关指标(入院24 h内)、临床诊疗及预后指标等。将患者分为重症急性胰腺炎(SAP)组(90例)与非SAP组(190例),比较两组各项指标的差异,并绘制受试者工作特征(ROC)曲线寻找PNI最佳诊断值;然后将SAP患者根据GPS和PNI分组比较其临床转归及预后。结果两组患者基线资料无明显统计学差异(P>0.05);与非SAP患者相比,SAP患者GPS评分2分明显更多(46.67%vs.11.05%,P<0.001),PNI指数明显更低(42.02 vs.46.30,P<0.001)。ROC曲线分析显示PNI指数最佳截断值为43.73。与A组相比,B组患者的ICU治疗率更高、时间更长(46.2%vs.25.5%,中位0 d vs.0 d,P=0.041,0.010),禁食时间更长(中位13 d vs.10 d,P=0.004),引流管数量更多(中位3根vs.2根,P=0.003),总住院时间更长(中位25 d vs.20 d,P=0.005),住院费用更高(中位154055.14元vs.126152.12元,P=0.004)、死亡率更高(33.3%vs.13.7%,P=0.027)。结论GPS评分和PNI指数对急性胰腺炎患者早期严重程度和SAP患者预后具有预测价值。展开更多
文摘BACKGROUND Gastric cancer is the third most common cause of cancer related death worldwide.Surgery with or without chemotherapy is the most common approach with curative intent;however,the prognosis is poor as mortality rates remain high.Several indexes have been proposed in the past few years in order to estimate the survival of patients undergoing gastrectomy.The preoperative nutritional status of gastric cancer patients has recently gained attention as a factor that could affect the postoperative course and various indexes have been developed.The aim of this systematic review was to assess the role of the prognostic nutritional index(PNI)in predicting the survival of patients with gastric or gastroesophageal adenocarcinoma who underwent gastrectomy with curative intent.AIM To investigate the role of PNI in predicting the survival of patients with gastric or gastroesophageal junction adenocarcinoma.METHODS A thorough literature search of PubMed and the Cochrane library was performed for studies comparing the overall survival(OS)of patients with gastric or gastroesophageal cancer after surgical resection depending on the preoperative PNI value.The PRISMA algorithm was used in the screening process and finally 16 studies were included in this systematic review.The review protocol was registered in the International Prospective Register of Systematic Reviews(PRO) RESULTS Sixteen studies involving 14551 patients with gastric or esophagogastric junction adenocarcinoma undergoing open or laparoscopic or robotic gastrectomy with or without adjuvant chemotherapy were included in this systematic review.The patients were divided into high-and low-PNI groups according to cut-off values that were set according to previous reports or by using receiver operating characteristic curve analysis in each individual study.The 5-year OS of patients in the low-PNI groups ranged between 39%and 70.6%,while in the high-PNI groups,it ranged between 54.9%and 95.8%.In most of the included studies,patients with high preoperative PNI showed statistically significant better OS than the low PNI groups.In multivariate analyses,low PNI was repeatedly recognised as an independent prognostic factor for poor survival.CONCLUSION According to the present study,low preoperative PNI seems to be an indicator of poor OS of patients undergoing gastrectomy for gastric or gastroesophageal cancer.
文摘BACKGROUND The prognostic nutritional index(PNI),a marker of immune-nutrition balance,has predictive value for the survival and prognosis of patients with various cancers.AIM To explore the clinical significance of the preoperative PNI on the prognosis of ampullary adenocarcinoma(AC)patients who underwent curative pancreaticoduodenectomy.METHODS The data concerning 233 patients diagnosed with ACs were extracted and analyzed at our institution from January 1998 to December 2020.All patients were categorized into low and high PNI groups based on the cutoff value determined by receiver operating characteristic curve analysis.We compared disease-free survival(DFS)and overall survival(OS)between these groups and assessed prognostic factors through univariate and multivariate analyses.RESULTS The optimal cutoff value for the PNI was established at 45.3.Patients with a PNI≥45.3 were categorized into the PNI-high group,while those with a PNI<45.3 were assigned to the PNI-low group.Patients within the PNI-low group tended to be of advanced age and exhibited higher levels of aspartate transaminase and total bilirubin and a lower creatinine level than were those in the PNI-high group.The 5-year OS rates for patients with a PNI≥45.3 and a PNI<45.3 were 61.8%and 43.4%,respectively,while the 5-year DFS rates were 53.5%and 38.3%,respectively.Patients in the PNI-low group had shorter OS(P=0.006)and DFS(P=0.012).In addition,multivariate analysis revealed that the PNI,pathological T stage and pathological N stage were found to be independent prognostic factors for both OS and DFS.CONCLUSION The PNI is a straightforward and valuable marker for predicting long-term survival after pancreatoduodenectomy.The PNI should be incorporated into the standard assessment of patients with AC.
文摘BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.
基金Supported by National Natural Science Foundation of China,No.81871946 and No.82072708Suzhou Medical Key Discipline,No.SZXK202109+1 种基金Suzhou Clinical Key Diseases Project,No.LCZX202111Project of Gusu School of Nanjing Medical University,No.GSKY20210233.
文摘BACKGROUND Remnant gastric cancer(GC)is defined as GC that occurs five years or more after gastrectomy.Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer(RGC)patients are crucial.A simple scoring system that combines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary.AIM To evaluate the value of preoperative immune-nutritional scoring systems in predicting the prognosis of patients with RGC.METHODS The clinical data of 54 patients with RGC were collected and analyzed retrospectively.Prognostic nutritional index(PNI),controlled nutritional status(CONUT),and Naples prognostic score(NPS)were calculated by preoperative blood indicators,including absolute lymphocyte count,lymphocyte to monocyte ratio,neutrophil to lymphocyte ratio,serum albumin,and serum total cholesterol.Patients with RGC were divided into groups according to the immune-nutritional risk.The relationship between the three preoperative immune-nutritional scores and clinical characteristics was analyzed.Cox regression and Kaplan–Meier analysis was performed to analyze the difference in overall survival(OS)rate between various immune-nutritional score groups.RESULTS The median age of this cohort was 70.5 years(ranging from 39 to 87 years).No significant correlation was found between most pathological features and immune-nutritional status(P>0.05).Patients with a PNI score<45,CONUT score or NPS score≥3 were considered to be at high immune-nutritional risk.The areas under the receiver operating characteristic curves of PNI,CONUT,and NPS systems for predicting postoperative survival were 0.611[95%confidence interval(CI):0.460–0.763;P=0.161],0.635(95%CI:0.485–0.784;P=0.090),and 0.707(95%CI:0.566–0.848;P=0.009),respectively.Cox regression analysis showed that the three immunenutritional scoring systems were significantly correlated with OS(PNI:P=0.002;CONUT:P=0.039;NPS:P<0.001).Survival analysis revealed a significant difference in OS between different immune-nutritional groups(PNI:75 mo vs 42 mo,P=0.001;CONUT:69 mo vs 48 mo,P=0.033;NPS:77 mo vs 40 mo,P<0.001).CONCLUSION These preoperative immune-nutritional scores are reliable multidimensional prognostic scoring systems for predicting the prognosis of patients with RGC,in which the NPS system has relatively effective predictive performance.
基金Supported by National Basic Research Program of China(973 Program),No.2010CB529301the Key Program for Anticancer Research of Tianjin Municipal Science and Technology Commission,No.12ZCDZSY16400
文摘AIM: To investigate the impact of prognostic nutritional index (PNI) on the postoperative complications and long-term outcomes in gastric cancer patients undergoing total gastrectomy.
基金supported in part by a grant from National Natural Science Foundation of China(No.81302144)the Guangdong Science and Technology Department(No.2012B061700087)
文摘Objective： The predictive and prognostic role of prognostic nutritional index（PNI） in gastric cancer patients with peritoneal dissemination remains unclear. This study aims to explore the role of the PNI in predicting outcomes of gastric cancer patients with peritoneal dissemination.Methods： A total of 660 patients diagnosed with gastric adenocarcinoma with peritoneal metastasis between January 2000 and April 2014 at Sun Yat-sen University Cancer Center and the Sixth Affiliated Hospital of Sun Yatsen University were retrospectively analyzed. The clinicopathologic characteristics and clinical outcomes of patients with peritoneal dissemination were analyzed.Results： Compared with PNI-high group, PNI-low group was correlated with advanced age（P=0.036）, worse performance status（P0.001）, higher frequency of ascites（P0.001） and higher frequency of multisite distant metastasis（P0.001）. Kaplan-Meier survival curves showed that PNI-high group had a significantly longer median overall survival than PNI-low group（13.13 vs. 9.03 months, P0.001）. Multivariate survival analysis revealed that Borrmann type IV（P=0.014）, presence of ascites（P=0.017） and lower PNI（P=0.041） were independent poor prognostic factors, and palliative surgery（P0.001） and first-line chemotherapy（P0.001） were good prognostic factors. For patients receiving palliative surgery, the postoperative morbidity rates in the PNI-low group and PNIhigh group were 9.1% and 9.9%, respectively（P=0.797）. The postoperative mortality rate was not significantly different between PNI-low and PNI-high groups（2.3% vs. 0.9%, P=0.362）.Conclusions： PNI is a useful and practical tool for evaluating the nutritional status of gastric cancer patients with peritoneal dissemination, and is an independent prognostic factor for these patients.
基金Supported by National Natural Science Foundation of China,Nos.81101865 and 81272637Doctoral Fund of the Ministry of Education of China,No.20110171120064+1 种基金Natural Science Foundation of Guangdong Province,No.S2013020012724Clinical Medicine Research Project 5010 of Sun Yat-sen University,No.2010006
文摘AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric cancer.METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate.Univariate and multivariate analyses were performed to identify risk factors for overall survival(OS). Propensity score analysis was performed to adjust variables to control for selection bias.RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring(hazard ratio, 1.668; 95% confidence interval:1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage Ⅱ-Ⅲ disease(P = 0.019, P < 0.001), T3-T4 tumors(P <0.001), or lymph node metastasis(P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS(P = 0.022, P = 0.030, P < 0.001, and P = 0.024,respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively.CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.
基金funded by the National Natural Science Foundation of China(No.81772595,81502459)Sun Yat-sen University Clinical Research 5010 Program(No.2015024,2013013)Science and Technology Planning Project of Guangdong Province(No.2013B021800146)
文摘Background: The prognostic nutritional index(PNI) has been widely applied for predicting survival outcomes of patients with various malignant tumors. Although a low PNI predicts poor prognosis in patients with colorectal cancer after tumor resection, the prognostic value remains unknown in patients with stage Ⅲ colon cancer undergoing curative tumor resection followed by adjuvant chemotherapy. This study aimed to investigate the prognostic value of PNI in patients with stage III colon cancer.Methods: Medical records of 274 consecutive patients with stage Ⅲ colon cancer undergoing curative tumor resection followed by adjuvant chemotherapy with oxaliplatin and capecitabine between December 2007 and December2013 were reviewed. The optimal PNI cutoff value was determined using receiver operating characteristic(ROC) curve analysis. The associations of PNI with systemic inflammatory response markers, including lymphocyte-to-monocyte ratio(LMR), neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), and C-reactive protein(CRP)level, and clinicopathologic characteristics were assessed using the Chi square or Fisher's exact test. Correlation analysis was performed using Spearman's correlation coefficient. Disease-free survival(DFS) and overall survival(OS)stratified by PNI were analyzed using Kaplan-Meier method and log-rank test, and prognostic factors were identified by Cox regression analyses.Results: The preoperative PNI was positively correlated with LMR(r= 0.483, P < 0.001) and negatively correlated with NLR(r =-0.441, P < 0.001), PLR(r =-0.607, P < 0.001), and CRP level(r =-0.333, P < 0.001). A low PNI(≤49.22)was significantly associated with short OS and DFS in patients with stage ⅢC colon cancer but not in patients with stage ⅢA/ⅢB colon cancer.In addition, patients with a low PNI achieved a longer OS and DFS after being treated with6-8 cycles of adjuvant chemotherapy than did those with < 6 cycles. Multivariate analyses revealed that PNI was independently associated with DFS(hazard ratios 2.001; 95% confidence interval 1.157-3.462; P = 0.013).Conclusion: The present study identified preoperative PNI as a valuable predictor for survival outcomes in patients with stage Ⅲ colon cancer receiving curative tumor resection followed by adjuvant chemotherapy.
文摘BACKGROUND Pancreaticoduodenectomy(PD) is a complex surgical procedure with a high morbidity rate. The serious complications are major risk factors for poor longterm surgical outcome. Studies have reported an association between early postoperative prognostic nutritional index(PNI) and prediction of severe complications after abdominal surgery. However, there have been no studies on the use of early postoperative PNI for predicting serious complications following PD.AIM To analyze the risk factors and early postoperative PNI for predicting severe complications following PD.METHODS We retrospectively analyzed 238 patients who underwent PD at our hospital between January 2007 and December 2017. The postoperative complications were classified according to the Dindo-Clavien classification. Grade Ⅲ-Ⅴ postoperative complications were classified as serious. The risk factors for serious complications were analyzed by univariate analysis and multivariate logistic regression analysis.RESULTS Overall complications were detected in 157 of 238 patients(65.9%) who underwent PD. The grade Ⅲ-Ⅴ complication rate was 26.47%(63/238 patients).The mortality rate was 3.7%(9/238 patients). Multivariate logistic regression analysis revealed that preoperative serum albumin [odds ratio(OR): 0.883, 95%confidence interval(CI): 0.80-0.96; P < 0.01] and PNI on postoperative day 3 <40.5(OR: 2.77, 95%CI: 1.21-6.38, P < 0.05) were independent factors associated with grade Ⅲ-Ⅴ postoperative complications.CONCLUSION Perioperative albumin is an important factor associated with serious complications following PD. Low early postoperative PNI(< 40.5) is a predictor for serious complications.
基金Supported by Health Commission of Shanxi Province,No.2020130 and No.2020TD27the Science and Technology Planning Project of Yangzhou City,No.YZ2018092。
文摘BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.
文摘Objective To compare the value and consistency among the Patient Generated-Subjective Global Assessment(PG-SGA)and the Prognostic Nutrition Index(PNI)for assessing nutritional status in gastrointestinal tumor patients.Methods 251 patients from gastric cancer surgical ward from January 2019 to January 2020 were recruited through convenience sampling in this respective study.Nutritional screening and assessment were conducted for 251 gastrointestinal tumor patients using the nutritional risk screening 2002(NRS 2002)PG-SGA,and the PNI.PNI was calculated using the serum albumin level and the total lymphocyte count obtained from the patients’routine laboratory examination when they were admitted to the hospital.The receiver operating characteristic(ROC)of the PG SGA and the PNI were plotted with the NRS 2002 used as the gold standard,and the diagnostic value of the PG-SGA and PNI was reflected by the area under the curve(AUC),sensitivity,specificity and Youden index.We then determined the optimal cut-off for the PNI and tested the consistency of the PG-SGA and PNI.Results The optimal cut-off point for the PNI was calculated to be 50.78.The AUC of the PG-SGA was 0.908(95%CI 0.871-0.944).The sensitivity was 89.9%,specificity was 76.2%and the Youden index was 0.661.The AUC of the PNI was 0.594(95%CI 0.516-0.572).The sensitivity was 73.8%,specificity was 44.3%and the Youden index was 0.181.In the consistency test,the kappa value was 0.838(P<0.001).Conclusion The PNI is of limited value for assessing malnutrition,although it did have good consistency with the PG-SGA.The combination of the PNI and PG-SGA can be used for diagnosing assessing malnutrition in clinical practice.
文摘In this editorial,I comment on the article by Li et al published in the recent issue of the World Journal of Gastrointestinal Surgery in 2023,investigating the role of some novel prognostic factors for early survival after radical resection of liver cancer.Liver cancer is an important burden among Asian and Western popu-lations,despite recent advances in both medicine(from virus eradication to systemic target therapies)and surgery.However,survival after proven radical surgery remains poor,with recurrences being the rule.Many prognostic scores have been developed and validated to select those patients who will best benefit from radical liver surgery,although the final general and oncological outcomes continue to be highly jeopardized.Unfortunately,no single biomarker can resolve all these issues for hepatocellular carcinoma,and it remains to be proven whether some of them main-tain predictive power in the long-term follow-up.In the ongoing era of“preci-sion”medicine,the novel prognostic markers,including immune inflammatory and nutritional indexes could be of great help in better stratify surgical candi-dates.
文摘This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer.Lu et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term outcomes.These biomarkers were albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,nutritional risk index,and geriatric nutritional risk index.The PNI was found to be a strong predictor of both overall and recurrence-free survival,underscoring its clinical relevance in managing patients with pancreatic cancer.
文摘BACKGROUND The incidence of prostate cancer(PCa)is on the rise in China.The risk level of patients with PCa is associated with disease-free survival rate at 10 years after radical prostatectomy.Predicting prognosis in advance according to the degree of risk can provide a reference for patients,especially treatment options and postoperative adjuvant treatment measures for high-risk/extremely high-risk patients.AIM To explore the predictive value of the prognostic nutritional index(PNI)for biological recurrence in Chinese patients with high/extremely high-risk PCa after radical prostatectomy.METHODS The biochemical test results and clinical data of 193 patients who underwent radical prostatectomy for the first time from January 2015 to December 2020 were retrospectively collected.The PNI value of peripheral blood within 1 wk before surgery was calculated,and during the follow-up period,prostate-specific antigen≥0.2 ng/mL was considered to have biological recurrence.The receiver operating characteristic(ROC)curve was used to calculate the optimal critical value and area under the curve(AUC)of the patients.According to the critical value,the progression-free survival of the high PNI group and low PNI group was compared.The independent influencing factors of the patients’prognosis were obtained by the Cox proportional hazards regression model.RESULTS The non-biological recurrence rates at 1,3,and 5 years were 92.02%,84.05%,and 74.85%,respectively.The optimal critical value for PNI to predict biological recurrence was 46.23,and the AUC was 0.789(95%confidence interval:0.651-0.860;P<0.001).The sensitivity and specificity were 82.93%and 62.30%,respectively.In accordance with the optimal critical value of the ROC curve(46.23),193 patients were further divided into a high PNI group(PNI≤46.23,n=108)and low PNI group(PNI>46.23,n=85).The incidence of postoperative complications in the high PNI group was lower than that in the low PNI group(21.18%vs 38.96%).Kaplan-Meier survival analysis showed that the overall survival rate at 5 years in the low PNI group was 87.96%(13/108),which was lower than that in the high PNI group(61.18%,33/85;P<0.05).Low PNI[hazard ratio(HR)=1.74;P=0.003]and positive incisal margin status(HR=2.14;P=0.001)were independent predictors of biological recurrence in patients with high/extremely high-risk PCa.CONCLUSION The PNI has predictive value for the prognosis of patients with high/extremely high-risk PCa,and is an independent prognostic factor.Patients with low PNI value have a shorter time of nonbiological recurrence after prostatectomy.It is expected that the combined prediction of other clinicopathological data will further improve the accuracy and guide postoperative adjuvant therapy to improve the quality of prognosis.
文摘目的探讨格拉斯哥预后评分(GPS)和预后营养指数(PNI)对早期预测急性胰腺炎严重程度和预后的临床应用价值。方法回顾性收集聊城市第二人民医院2019年1月1日—2023年3月31日连续收治的280例急性胰腺炎患者的临床资料,包括患者一般临床资料、实验室各项相关指标(入院24 h内)、临床诊疗及预后指标等。将患者分为重症急性胰腺炎(SAP)组(90例)与非SAP组(190例),比较两组各项指标的差异,并绘制受试者工作特征(ROC)曲线寻找PNI最佳诊断值;然后将SAP患者根据GPS和PNI分组比较其临床转归及预后。结果两组患者基线资料无明显统计学差异(P>0.05);与非SAP患者相比,SAP患者GPS评分2分明显更多(46.67%vs.11.05%,P<0.001),PNI指数明显更低(42.02 vs.46.30,P<0.001)。ROC曲线分析显示PNI指数最佳截断值为43.73。与A组相比,B组患者的ICU治疗率更高、时间更长(46.2%vs.25.5%,中位0 d vs.0 d,P=0.041,0.010),禁食时间更长(中位13 d vs.10 d,P=0.004),引流管数量更多(中位3根vs.2根,P=0.003),总住院时间更长(中位25 d vs.20 d,P=0.005),住院费用更高(中位154055.14元vs.126152.12元,P=0.004)、死亡率更高(33.3%vs.13.7%,P=0.027)。结论GPS评分和PNI指数对急性胰腺炎患者早期严重程度和SAP患者预后具有预测价值。
