Geriatric Nutritional Risk Index (GNRI) and Prognostic Nutritional Index (PNI) Before Treatment as the Predictive Indicators for Bone Metastasis in Prostate Cancer Patients.

Abstract

Objective: Inflammation and nutritional status are involved in the occurrence and progression of cancer. The purpose of this study was to investigate the relationship of nutritional status indices (geriatric nutritional risk index (GNRI), neutrophil to albumin ratio (NAR), prognostic nutritional index (PNI)), and comprehensive inflammatory indices (pan-immune inflammation value (PIV), systemic immune inflammation index (SII), and system inflammation response index (SIRI)) and bone metastasis of prostate cancer.

Methods: A retrospective analysis was performed on 888 prostate cancer patients treated in Meizhou People's Hospital from November 2017 to December 2022. Clinical characteristics were collected, including age, body mass index (BMI), bone metastasis, and GNRI, NAR, PNI, PIV, SII, and SIRI levels. The optimal cutoff values of these indices were calculated by receiver operating characteristic (ROC) curve, and the relationship between these indices and bone metastasis was analyzed.

Results: There were 836 (94.1%) cases were ≥60 years old, indicating that the majority of prostate cancer patients were elderly men. There were 640 (72.1%) patients without bone metastasis and 248 (27.9%) patients with bone metastasis. The levels of GNRI and PNI in patients with bone metastasis were significantly lower than those without, while NAR, PIV, SII, and SIRI were not statistically significant. And the levels of GNRI and PNI in patients with multiple bone metastasis were significantly lower than those with single bone metastasis. When bone metastasis was taken as the endpoint of GNRI and PNI, the critical value of GNRI was 97.05 (sensitivity 55.2%, specificity 67.5%, area under the ROC curve (AUC) = 0.639), the PNI cutoff value was 44.925 (sensitivity 51.2%, specificity 67.2%, AUC = 0.634), and the AUC of GNRI plus PNI was 0.647.

Conclusion: Prostate cancer is more common in older men; about a quarter of patients have bone metastasis. GNRI and PNI have predictive efficacy in bone metastasis and multiple bone metastasis of prostate cancer, but NAR, PIV, SII, and SIRI do not.