CAJ | 학술논문

目的：探讨预后营养指数（prognostic nutritional index，PNI）与胃癌术后患者的不良反应发生及预后的关系。方法：回顾性分析2006年1月～2014年6月128例经病理确诊为胃癌并行胃癌根治切除术患者的临床随访病例资料。通过对ROC曲线得出PNI的最佳截断值，根据最佳截断值将患者分为PNI高值组及PNI低值组，比较两组的临床病理学特征。采用Cox比例风险模型研究胃癌术后患者预后的影响因素。结果：以PNI值＝50.1为最佳截断值时，约登指数为最大值，敏感度为64.6％，特异度为34.5％。PNI低值组中年龄≥65岁、肿瘤大小≥5 cm、侵袭深度为T3或T4、淋巴结转移、发生术后并发症的比例较高。多因素生存分析显示：PNI值、侵袭深度、淋巴结转移、术后并发症是胃癌患者术后预后的独立影响因素。结论：PNI值的计算简便，可用于初步判断胃癌患者术后的预后状况。
목적：탐토예후영양지수（prognostic nutritional index，PNI）여위암술후환자적불량반응발생급예후적관계。방법：회고성분석2006년1월～2014년6월128례경병리학진위위암병행위암근치절제술환자적림상수방병례자료。통과대ROC곡선득출PNI적최가절단치，근거최가절단치장환자분위PNI고치조급PNI저치조，비교량조적림상병이학특정。채용Cox비례풍험모형연구위암술후환자예후적영향인소。결과：이PNI치＝50.1위최가절단치시，약등지수위최대치，민감도위64.6％，특이도위34.5％。PNI저치조중년령≥65세、종류대소≥5 cm、침습심도위T3혹T4、림파결전이、발생술후병발증적비례교고。다인소생존분석현시：PNI치、침습심도、림파결전이、술후병발증시위암환자술후예후적독립영향인소。결론：PNI치적계산간편，가용우초보판단위암환자술후적예후상황。
Objective:To explore the application of prognostic nutritional index (PNI)in predicting the postoper-ative complications and long-term outcomes in gastric cancer patients undergoing gastrectomy.Methods:The data for 128 patients with pathologically proved gastric cancer who accepted gastrectomy in our hospital between January 2006 and June 2014 were extracted and analyzed.Subjects were divided into two groups according to the cutoff value of the PNI.Clinico-pathological features were compared between the two groups and potential prognostic factors were analyzed.The Cox propor-tional hazard model was used to explore the influencing factors.Results:The optimal cutoff value of the PNI was set at 50.1 ,and patients with PNI≥50.1 and those with PNI<50.1 were classified into PNI-high and PNI-low groups,respec-tively.Patients in the PNI-low group were more likely to be older than 65 years old,had larger tumor size (≥5cm)and deeper invasion depth (T3 and T4 ),had lymph node metastasis (N)and higher incidence of postoperative complications when comparing with those in the PNI-high group.The multivariate analyses showed that PNI value,depth of invasion, lymph node metastasis and postoperative complications were independent factors in predicting overall survival rate of pa-tients who underwent gastrectomy.Conclusion:PNI is recommended to identify the prognosis of gastric cancer patients ac-cepted gastrectomy with its easy way of calculation.