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中国癌症防治杂志

中国癌症防治杂志 ›› 2022, Vol. 14 ›› Issue (2): 184-189.doi: 10.3969/j.issn.1674-5671.2022.02.09

• 临床研究 • 上一篇    下一篇

新辅助化疗所致预后营养指数降低预示乳腺癌患者预后不良：一项单中心回顾性队列研究

  

  1. 首都医科大学附属北京世纪坛医院肿瘤内科 
  • 出版日期:2022-04-25 发布日期:2022-05-11
  • 基金资助:
    北京市医院管理局重点医学专业发展计划（ZYLX201816）

Decreased prognostic nutritional index caused by neoadjuvant chemotherapy indicates poor prognosis for breast cancer patients: a singlecenter retrospective cohort study

  • Online:2022-04-25 Published:2022-05-11

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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。

关键词:  , 乳腺癌；预后营养指数；新辅助化疗；无病生存期

Abstract: Objective To evaluate the impact of the prognostic nutritional index (PNI) on the prognosis of the breast cancer patients receiving neoadjuvant chemotherapy (NAC). Methods A 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. Results A 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 that ΔPNI, 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.

Key words: Breast cancer, Prognostic nutritional index, Neoadjuvant chemotherapy, Disease-free survival

中图分类号: 

  • R737.9