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| 预后营养指数(PNI)在乳腺癌患者预后评估中的应用与价值 |
| Application and Value of Prognostic Nutritional Index (PNI) in Prognostic Assessment of Breast Cancer Patients |
| 投稿时间：2024-10-13 修订日期：2024-12-03 |
| DOI： |
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| 中文关键词: 预后营养指数 乳腺癌 预后 |
| 英文关键词:Prognostic Nutritional Index Breast cancer Prognosis |
| 基金项目: |
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| 摘要点击次数: 49 |
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| 中文摘要: |
| 目的 本研究旨在探讨预后营养指数（Prognostic Nutritional Index, PNI）在乳腺癌患者预后评估中的潜在价值。PNI作为一种反映免疫营养状态的综合评估指标，近年来在多种恶性肿瘤的预后评估中逐渐受到关注，但在乳腺癌领域的应用仍较为有限。本研究通过回顾性分析，评估PNI对乳腺癌患者预后的预测能力。
方法 本研究回顾性分析了我院外科自2013年6月至2018年6月间接受手术治疗的165例乳腺癌患者的临床资料。通过受试者工作特征曲线（Receiver Operating Characteristic, ROC）分析确定PNI的最佳截点值，进一步探讨PNI与患者的临床病理特征及其预后之间的关系。研究重点分析了PNI水平与患者年龄、淋巴结转移情况以及肿瘤分期的相关性，旨在全面了解PNI对乳腺癌患者长期生存的影响。
结果 ROC曲线分析显示，PNI的最佳截点值为50.29。PNI水平显著与乳腺癌患者的年龄、淋巴结转移状态以及肿瘤分期密切相关（均P＜0.05）。进一步的生存分析表明，高PNI（≥50.29）组患者的5年无瘤生存率（81.0%）和5年总生存率（89.5%）均显著高于低PNI（＜50.29）组患者（分别为55.0%和76.7%），差异具有统计学意义（均P＜0.001）。单因素分析结果显示，患者的年龄、淋巴结转移状态、肿瘤分期以及PNI水平是影响乳腺癌患者无病生存期（Disease-Free Survival, DFS）和总生存期（Overall Survival, OS）的显著危险因素。此外，Cox多因素分析表明，PNI水平是影响乳腺癌患者DFS和OS的独立预后因素，其中PNI对DFS的影响具有显著统计学意义（HR: 0.544; 95% CI: 0.357~0.806; P=0.008），对OS的影响也同样显著（HR: 0.489; 95% CI: 0.279~0.867; P=0.012）。
结论 本研究结果表明，PNI作为一种综合反映患者营养与免疫状态的指标，能够有效预测乳腺癌患者的生存预后。PNI不仅简单易测，且可作为乳腺癌患者术前评估的重要参考指标，为临床医生提供更多决策依据，促进个体化治疗方案的制定。
关键词 预后营养指数；乳腺癌；预后评估 |
| 英文摘要: |
| Objective This study aimed to explore the potential value of the Prognostic Nutritional Index (PNI) in predicting the prognosis of breast cancer patients. PNI, as a comprehensive evaluation index based on immune and nutritional status, has gained attention in the prognosis of various malignancies in recent years. However, its application in the field of breast cancer remains limited. Therefore, this study retrospectively analyzed the prognostic predictive capability of PNI in breast cancer patients.
Methods This study retrospectively analyzed the clinical data of 165 breast cancer patients who underwent surgical treatment in our department between June 2013 and June 2018. The optimal cut-off value of PNI was determined by Receiver Operating Characteristic (ROC) curve analysis, and the relationship between PNI and the clinicopathological characteristics and prognosis of the patients was further investigated. The study focused on analyzing the correlation between PNI levels and patient age, lymph node metastasis, and tumor stage, aiming to comprehensively understand the impact of PNI on long-term survival in breast cancer patients.
Results ROC curve analysis showed that the optimal cut-off value of PNI was 50.29. PNI levels were significantly correlated with the age, lymph node metastasis status, and tumor stage of breast cancer patients (all P＜0.05). Further survival analysis revealed that the 5-year disease-free survival (DFS) rate (81.0%) and 5-year overall survival (OS) rate (89.5%) in the high PNI (≥50.29) group were significantly higher than those in the low PNI (<50.29) group (55.0% and 76.7%, respectively), with statistically significant differences (both P＜0.001). Univariate analysis showed that age, lymph node metastasis status, tumor stage, and PNI levels were significant risk factors affecting the progression-free survival (PFS) and overall survival (OS) of breast cancer patients. Furthermore, Cox multivariate analysis indicated that PNI level was an independent prognostic factor affecting DFS (HR: 0.544; 95% CI: 0.357-0.806; P=0.008) and OS (HR: 0.489; 95% CI: 0.279-0.867; P=0.012) in breast cancer patients.
Conclusion The results of this study suggest that PNI, as a comprehensive indicator based on the nutritional and immune status of patients, can effectively predict the prognosis of breast cancer patients. PNI is not only simple to measure but also serves as an important reference index for preoperative evaluation in breast cancer patients, providing clinicians with additional decision-making information and facilitating the development of individualized treatment plans. |
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