摘要
目的探讨治疗前预后营养指数(PNI)及营养相关指标对脑胶质瘤患者预后的预测价值。方法回顾性收集2015年1月—2020年12月宜宾市2家医院收治的210例脑胶质瘤患者的临床资料,随访截止日期为2022年12月30日。绘制受试者工作特征(ROC)曲线,计算各指标预测患者预后的曲线下面积(AUC)和最佳截断值;采用Kaplan-Meier法绘制生存曲线,通过Log-rank检验和多因素Cox回归分析探讨患者预后的影响因素。结果210例患者平均总生存期为21.8个月,随访期内死亡140例(占66.7%),患者1年生存率为54.6%。ROC曲线分析结果显示,白蛋白、前白蛋白、淋巴细胞、PNI和体质量指数预测脑胶质瘤患者预后的AUC分别为0.856、0.689、0.833、0.927和0.647,最佳截断值分别为36.0 g/L、205.0 mg/L、1.85×10^(9)/L、46.5和21.0 kg/m^(2)。多因素Cox回归分析结果显示,PNI、白蛋白、世界卫生组织(WHO)分级均为脑胶质瘤患者预后的影响因素(P<0.05)。生存曲线分析结果显示,PNI<46.5和PNI≥46.5患者的1年生存率分别为35.1%和84.2%,白蛋白<36.0 g/L和白蛋白≥36.0 g/L患者的1年生存率分别为35.8%和74.3%,WHO分级Ⅱ级、Ⅲ级和Ⅳ级患者的1年生存率分别为90.2%、55.2%和16.3%。结论脑胶质瘤患者预后与PNI、白蛋白和WHO分级有关,其中PNI对脑胶质瘤患者预后具有较高的预测价值。
Objective To investigate the predictive value of pre-treatment prognostic nutritional index(PNI)and nutrition-related indicators on the prognosis of patients with brain glioma.Methods The clinical data of 210 patients with brain glioma admitted to two hospitals in Yibin City from January 2015 to December 2020 were retrospectively collected,with the follow-up deadline on December 30,2022.The receiver operating characteristic(ROC)curve was plotted to calculate the area under the curve(AUC)and the optimal cut-off value of each indicator for predicting patients′prognosis.The Kaplan-Meier method was used to plot the survival curve,and the influencing factors of prognosis of patients were explored through Log-rank test and multivariate Cox regression analysis.Results The average overall survival time of 210 patients was 21.8 months,and 140 patients(66.7%)died during the follow-up period,with a 1-year survival rate of 54.6%.ROC curve analysis results showed that the AUCs of albumin,prealbumin,lymphocytes,PNI,and body mass index for predicting the prognosis of patients with brain glioma were 0.856,0.689,0.833,0.927,and 0.647,with the optimal cut-off values of 36.0 g/L,205.0 mg/L,1.85×10^(9)/L,46.5,and 21.0 kg/m^(2),respectively.The results of multivariate Cox regression analysis showed that PNI,albumin,and World Health Organization(WHO)grading were all influencing factors for the prognosis of patients with brain glioma(P<0.05).The survival curve analysis results showed that the 1-year survival rates of patients with PNI<46.5 and PNI≥46.5 were 35.1%and 84.2%,respectively,were 35.8%and 74.3%,respectively in patients with albumin<36.0 g/L and albumin≥36.0 g/L,and were 90.2%,55.2%,and 16.3%,respectively in patients with WHO grades ofⅡ,Ⅲ,andⅣ.Conclusion The prognosis of patients with brain glioma is related to PNI,albumin,and WHO grading,and PNI has a high predictive value for the prognosis of patients with brain glioma.
作者
曾晓玲
刘洋
方芳
童金平
王志敏
张睿
ZENG Xiaoling;LIU Yang;FANG Fang;TONG Jinping;WANG Zhimin;ZHANG Rui(Department of Neurosurgery,the Second People′s Hospital of Yibin City of Sichuan Province,Yibin,Sichuan,644000;Department of Neurosurgery,the First People′s Hospital of Yibin City of Sichuan Province,Yibin,Sichuan,644000;Department of Orthopedics,the First People′s Hospital of Yibin City of Sichuan Province,Yibin,Sichuan,644000)
出处
《实用临床医药杂志》
CAS
2024年第13期19-23,共5页
Journal of Clinical Medicine in Practice
基金
四川省卫健委普及应用科研项目(18PJ541)。
