摘要
目的 评估预后营养指数(prognostic nutritional index,PNI)变化对接受新辅助化疗(neoadjuvant chemotherapy,NAC)乳腺癌患者预后的影响。方法 本研究为一项单中心、回顾性队列研究。选2008年1月至2017年12月在本院接受NAC和手术切除的乳腺癌患者为研究对象,随访截至2020年12月。主要研究终点为无病生存期。采用时间依赖的ROC曲线计算NAC前PNI(pre-PNI)、NAC后PNI(post-PNI)以及NAC前后PNI(ΔPNI)的截断值,采用Cox比例风险回归分析PNI与无病生存期的关联性。结果 共131例患者符合标准纳入研究。NAC后PNI较NAC前降低(46.4±4.5 vs 52.5±4.2,P<0.001)。ΔPNI的截断值为5.26。高ΔPNI组的无病生存率明显低于低ΔPNI组(P<0.001)。多因素Cox比例风险回归显示,ΔPNI、NAC前的临床分期、HER-2均是无病生存期的独立影响因素(均P<0.05)。结论 NAC期间PNI降低提示预后不良。在NAC期间保持良好营养状态可能会为乳腺癌患者带来更好的治疗结果。
ObjectiveTo evaluate the impact of the prognostic nutritional index(PNI) on the prognosis of the breast cancer patients receiving neoadjuvant chemotherapy(NAC).MethodsA single-center,retrospective cohort study was performed on the breast cancer patients,who underwent NAC and surgical resection in Internal Medicine-Oncology Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2008 to December 2017,were selected as the research subjects,and the follow-up was as of December 2020.The main study endpoint was the disease-free survival.The cut-off values of PNI before NAC(pre-PNI),PNI after NAC(post-PNI),and PNI before and after NAC(ΔPNI) were calculated by the time-dependent ROC curve.The association between PNI and disease-free survival was analyzed by Cox proportional hazard regression.ResultsA total of 131 patients met the criteria.The post-PNI was lower than pre-PNI(46.4±4.5 vs 52.5±4.2,P<0.001).The cut-off value of ΔPNI was 5.26.The disease-free survival rate of the high ΔPNI group was significantly lower than that of the low ΔPNI group(P<0.001).Further multivariable Cox proportional hazard regression showed thatΔPNI,pre-NAC clinical stage,and HER-2 were independent influencing factors of the disease-free survival(all P<0.05).Conclusions The decrease in PNI during NAC indicates a poor prognosis.Maintaining a nutritional status during NAC may yield better treatment results for the breast cancer patients.
作者
梁丽红
王维
杨芳
LIANG Lihong;WANG Wei;YANG Fang(Internal Medicine-Oncology Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China)
出处
《中国癌症防治杂志》
CAS
2022年第2期184-189,共6页
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
基金
北京市医院管理局重点医学专业发展计划(ZYLX201816)。
关键词
乳腺癌
预后营养指数
新辅助化疗
无病生存期
Breast cancer
Prognostic nutritional index
Neoadjuvant chemotherapy
Disease-free survival
