The role of the prognostic nutritional index as a prognostic factor in patients with hepatocellular carcinoma.

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-04-01 DOI:10.1016/j.aohep.2025.101864

Vilma Hernandez-Garza, Berenice Lorenzo-Valle, Kenia Michel Bastida-Guadarrama, Santiago Camacho-Hernandez, Fátima Higuera-de-la-Tijera

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引用次数: 0

Abstract

Introduction and Objectives

Immune-nutritional status has been demonstrated to be associated with prognosis in patients with various malignancies. The aim of this study is to determine the association of the nutritional prognostic index (PNI) with survival and assess the correlation between PNI and clinic-pathological parameters in HCC patients.

Materials and Patients

An observational, retrospective, descriptive and case series study was performed. We included 69 patients from a third-level hospital with a diagnosis of HCC from February 01, 2019 to July 24, 2023 and studied their survival 12 months after diagnosis. We determined the association between PNI status and their clinic-pathological characteristics and evaluated the impact of PNI on the HCC patient survival. The following formula was used to determine PNI: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per µL). Clinic-pathological characteristics related to disease prognosis included age, sex, body mass index (BMI), alpha-fetoprotein (AFP) value, the presence or not of cirrhosis, tumor size, ECOG score, and BCLC grade. Qualitative data are expressed as percentages and quantitative data as mean±SD. Statistical comparison was performed with two-tailed unpaired Student's t-test or chi-square and Fisher's exact test. Statistical significance was defined as P<0.05.

Results

Of the 69 patients diagnosed with HCC, most of the studied population was found to involve males at 56.52% while females were reported at 43.48%, with an age range of 26-81 years and a median age of 61.84, 61.84±9.8 (59.53-64.15). Of the total sample, 10.14% were patients with no diagnosis of cirrhosis while 89.86% were patients with some degree of cirrhosis (Child Pugh Stages: A 37.68%, B 43.48%, C 8.70%). The results indicated that low PNI is associated with poor prognosis while high PNI was found to be beneficial for survival with a 95 % CI=35.48±8.41 (32.42-38.54), 95% CI=40.86±5.42 (39.19-42.54) p=0.0019, respectively. It is also associated with more favorable outcomes, such as lower AFP, lower ECOG grade and lower BCLC staging (p=0.0371, p=0.0303, p= 0.002), respectively. However, we found that age, sex, presence or absence of cirrhosis, BMI and tumor size were not statistically significantly associated with the PNI value.

Conclusions

PNI is an independent predictive indicator of survival and is significantly associated with serum AFP, ECOG score, and BCLC stage in patients with HCC.

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预后营养指数作为肝细胞癌患者预后因素的作用。

免疫营养状况已被证明与各种恶性肿瘤患者的预后相关。本研究的目的是确定HCC患者营养预后指数（PNI）与生存的关系，并评估PNI与临床病理参数之间的相关性。材料和患者进行了观察性、回顾性、描述性和病例系列研究。我们纳入了2019年2月1日至2023年7月24日在一家三级医院诊断为HCC的69例患者，并研究了他们在诊断后12个月的生存率。我们确定了PNI状态与其临床病理特征之间的关系，并评估了PNI对HCC患者生存的影响。PNI测定公式如下：10 × 血清白蛋白（g/dL） + 0.005 × 总淋巴细胞计数（每µL）。与疾病预后相关的临床病理特征包括年龄、性别、体重指数（BMI）、甲胎蛋白（AFP）值、是否存在肝硬化、肿瘤大小、ECOG评分和BCLC分级。定性数据以百分比表示，定量数据以mean±SD表示。统计学比较采用双尾非配对学生t检验或卡方检验和Fisher精确检验。统计学意义定义为P<；0.05。结果69例HCC患者中，男性占56.52%，女性占43.48%，年龄26 ~ 81岁，中位年龄61.84,61.84±9.8（59.53 ~ 64.15）岁。总样本中，10.14%为未诊断为肝硬化的患者，89.86%为有一定程度肝硬化的患者（Child Pugh分期：A 37.68%, B 43.48%, C 8.70%）。结果显示，低PNI与预后差相关，高PNI有利于生存，95% CI=35.48±8.41 (32.42 ~ 38.54),95% CI=40.86±5.42 (39.19 ~ 42.54)p=0.0019。它还与更有利的结果相关，如AFP降低，ECOG分级降低，BCLC分期降低（p=0.0371, p=0.0303, p= 0.002）。然而，我们发现年龄、性别、有无肝硬化、BMI和肿瘤大小与PNI值无统计学意义相关。结论spni是HCC患者独立的生存预测指标，与血清AFP、ECOG评分、BCLC分期有显著相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.