Pan-Immune-Inflammation Value (PIV) and Prognostic Nutritional Index (PNI) are Associated with Distant Metastasis in Colorectal Cancer with KRAS Mutation but Not in Those with KRAS Wild-Type.

IF 2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of General Medicine Pub Date : 2025-09-10 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S541575

Yunlin Li, Yuwen Zeng

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Abstract

Background: Pan-immune-inflammation value (PIV) and prognostic nutritional index (PNI) have values in the prognosis assessment of tumors. However, their relationship with the distant metastasis risk of colorectal cancer (CRC) remains unclear. The aim of our study was to explore the relationship between PIV and PNI and the risk of distant metastasis in CRC patients with and without KRAS mutation.

Methods: The clinical data (age, gender, body mass index (BMI), cigarette smoking, alcoholism, and diabetes mellitus, family history of tumor, tumor stage, and KRAS/NRAS mutation status) of 2408 CRC patients were retrospectively collected and analyzed. The optimal thresholds of PIV and PNI were evaluated by receiver operating characteristic (ROC) curve analysis. Logistic regression analysis was used to reveal the relationship of PIV and PNI and distant metastasis in CRC with and without KRAS mutation, respectively.

Results: The average levels of PIV and PNI was 327.62 (183.19, 590.36) and 46.70 (43.10, 50.90). There were 825 (34.3%) patients with distant metastasis and 1583 (65.7%) without. The optimal threshold of PIV and PNI was 339.50 and 45.53 by ROC analysis. Logistic regression analysis showed that stage T3-T4 (odds ratio (OR): 2.967, 95% confidence interval (CI): 1.804-4.880, p<0.001), and stage N2-N3 (OR: 5.109, 95% CI: 3.886-6.717, p<0.001) were associated with distant metastasis in CRC with KRAS wild-type; while stage T3-T4 (OR: 5.963, 95% CI: 2.897-12.273, p<0.001), and stage N2-N3 (OR: 7.094, 95% CI: 5.070-9.926, p<0.001), high PIV (OR: 2.867, 95% CI: 2.119-3.879, p<0.001), and low PNI (OR: 1.620, 95% CI: 1.184-2.215, p=0.003) were associated with distant metastasis in CRC with KRAS mutation.

Conclusion: Stages T3-T4 and N2-N3 were associated with distant metastasis in CRC with and without KRAS mutation. High PIV and low PNI were associated with distant metastasis in CRC patients with KRAS mutation, but not in patients without KRAS mutation.

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泛免疫炎症值（PIV）和预后营养指数（PNI）与KRAS突变的结直肠癌远处转移相关，而与KRAS野生型无关。

背景：泛免疫炎症值（Pan-immune-inflammation value， PIV）和预后营养指数（prognosis nutritional index， PNI）在肿瘤预后评估中具有一定价值。然而，它们与结直肠癌（CRC）远处转移风险的关系尚不清楚。我们的研究目的是探讨PIV和PNI与KRAS突变和非KRAS突变的CRC患者远处转移风险的关系。方法：回顾性收集2408例结直肠癌患者的临床资料（年龄、性别、体重指数（BMI）、吸烟、酗酒、糖尿病、肿瘤家族史、肿瘤分期、KRAS/NRAS突变状态）进行分析。采用受试者工作特征（ROC）曲线分析评价PIV和PNI的最佳阈值。采用Logistic回归分析分别揭示KRAS突变和非KRAS突变的CRC中PIV和PNI与远处转移的关系。结果：PIV和PNI平均水平分别为327.62（183.19,590.36）和46.70（43.10,50.90）。有远处转移825例（34.3%），无远处转移1583例（65.7%）。经ROC分析，PIV和PNI的最佳阈值分别为339.50和45.53。Logistic回归分析显示T3-T4期(优势比（OR）： 2.967, 95%可信区间（CI）： 1.804-4.880， ppKRAS野生型；T3-T4期（OR: 5.963, 95% CI: 2.897-12.273, pppp=0.003）与KRAS突变的结直肠癌远处转移相关。结论：伴有或不伴有KRAS突变的结直肠癌的T3-T4期和N2-N3期与远处转移相关。在KRAS突变的结直肠癌患者中，高PIV和低PNI与远处转移相关，而在无KRAS突变的结直肠癌患者中则无关。

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来源期刊

International Journal of General Medicine Medicine-General Medicine

自引率

0.00%

发文量

1113

审稿时长

16 weeks

期刊介绍： The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.