现代肿瘤医学2016年07月第24卷第13期
MODERN ONCOLOGY,Jul. 2016,VOL 24, NO.13
预后营养指数在原发性肝癌肝切除患者预后评估中的价值
军岩"，王志鑫"2，苗润晨"，陈伟”，周延岩"，吴云桦”，毕建斌"，曲凯”，刘昌” 邓
·2107 ·
Prognostic significance of thepreoperative prognostic nutritional indexfor hepatocellular carcinomapafientsundergoingsurgicalresection
Deng Yan', Wang Zhixin',2,Miao Runchen',Chen Wei',Zhou Yanyan', Wu Yunhua',Bi Jianbin',Qu Kai', Liu Chang
'Department of Hepatobiliary Surgery;"Department of General Surgery,the First Afiliated Hospital of Xian Jiaotong Unirersity,Shaanxi Xian 710061,China;"Department of Hepatopancreatobiliary Surgery,Afiliated Hospital of Qinghai University,Qinghai Xining 810000, China.
[Abstract] Objective: To investigate the impact of prognostic nutritional index ( PNI) on the clinicopathological features and the long term outcomes of hepatocellular carcinoma ( HCC) after surgical resection, Methods : The clin ical and follow up records of 172 patients with hepatocellular carcinoma undergoing resection surgery were analyzed retrospectively. Preoperative serum albumin and lymphocyte counts were obtained. The PNI value was calculated by serum albumin concentration ( g/L) + 5 × lymphocyte count (10°/L). All patients were divided into two groups based
on the PNI value ( PNI≥45 was defined as high PNI. PNI <45 w
s defined as low PNI). Multivariate and stratifi-
cation analysis were used to assess the correlation between the PNI and the patients'prognosis, Results: Compared
with the high PNI group, patients in the low PNI e
were older (P <0. 05). Besides,the patients in the low -
PNI group had a higher incidence of live fibrosis than those in the high PNI group ( P <0. 05). In univariate analy-
sis,the result hinted that the PNI,
operative patients. Multivariate Cox
mbous
analvsisfurtherindicated that
with patientsoverall survival, with TNM
dHiBybein
to confirm the result. In addition,76 patients had t
might affect the overall survival of post an independent protective factor associated
g independent risk factors.Subgroup analysis was used
rgical resection. Nevertheless,the result of
the multivariate Cox analysis failed to find the statistics difference between the high PNI group and the low PNI group. Hence,PNI is not the independent protective factor of tumor recurrence, Conclusion ; PNI is a convenient and useful index to predict the prognosis of the patients with HCC.
[Key words] prognostic nutritional index,hepatocellular carcinoma,hepatectomy, prognosis
Modem Oncology 2016,24(13) :2107 2112
【摘要】
目的：评价预后营养指数(PNI)在接受根治性肝切除的原发性肝癌患者预后评估中的意义及价值。
肝癌患者病例及随访资料,根据患者术前的血清白蛋白和总的淋巴细胞计数算出PNI值，分析PNI与患者临床病理特征及预后的关系。结果：预后危险因索分析显示：PNI是影响肝癌切除术后患者生存率的独立危险因素（P<0.05），高PNI组患者的5年累计生存率为56.20%，而低PNI组仅为36.10%，差异显著（P= 0.01）。分层分析发现在早期肝瘤患者中，PNI亚组间的总体生存存在显著差异（P<0.05），面在晚期患者中差异不明显(P>0.05)。结论：PNI是影响原发性肝癌切除术后患者生存情况的独立危险因素，但对术后肿瘤的复发作用不明显。
【关键词】预后营养指数；原发性肝瘤；肝切除术；预后
【中图分类号】R735.7
【文献标识码】A
【文章编号】16724992(201613210706
【收稿日期】【作者单位】
【作者简介】【通讯作者】
2016 02 05
DOI:10.3969/j. issn, 1672 4992.2016.13.027
"西安交通大学第一附属医院肝胆外科；"普通外科，陕西
西安710061
3青海大学附属医院肝胆胰外科，青海西宁810000
邓岩（1990-），男，潮北荆州人，在读硕士，主要从事原发性肝瘤的临床研究。E-mail;dengyanjiayou3@163，com
刘昌(1967-），女，河北保定人，主任医师，博士生导师，主要从事原发性肝癌及门静脉高压的临床及基础研究。E-mail：li-uchangdoctor163.com