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| The prognostic nutritional index and nutritional risk screening 2002 of lung cancer patients was analyzed by Cox proportional
hazards model |
| Zhang Hong, Chen Zhaojun, Shi Zhenjing |
| Department of Thoracic Surgery Shanghai Pulmonary Hospital Affiliated to Tongji University Shanghai 200000 China |
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Abstract Objective Exploring the predictive value of prognostic nutritional index PNI and nutritional risk screening 2002
NRS2002 in predicting the prognosis of lung cancer patients using Cox proportional hazards model analysis. Method According to the
inclusion and exclusion criteria a retrospective analysis was conducted on the clinical data of 652 lung cancer patients admitted to
Shanghai Pulmonary Hospital from June 2021 to June 2023. Patients were followed up for 14 months after surgery and divided into two
groups based on their prognosis Survival group n = 587 and death group n = 65 . The basic situation of the two groups was
compared and a single factor was used to preliminarily select candidate factors. Cox proportional hazards analysis was conducted on
variables with statistical differences to establish a prediction model. Receiver operating characteristic ROC curves were drawn to test
the effectiveness of the prediction model. Meanwhile it is necessary to use the Kaplan Meier survival model to analyze the relationship
between different PNI and NRS 2002 scores and survival. Result After 14 months of follow-up 587 patients with 652 lung cancer
patients had no progression and 65 patients died or relapsed. Compared with the survival group the death group had a higher age of
66-70 years a history of alcohol consumption TNM stage Ⅲ PNI <45 and a higher NRS 2002 score of ≥3 before treatment which
was statistically significant P<0. 05 . According to Cox proportional hazards analysis TNM staging PNI<45、A NRS 2002 score of≥3
before treatment is a prognostic factor for lung cancer patients P<0. 05 . Based on these factors a prediction model was established
and validated using Bootstrap method. The ROC curve area was 0. 745 and the 95%CI was 0. 680-0. 810. This model can effectively
predict the prognosis of patients. Meanwhile Kaplan Meier survival analysis showed that patients with PNI≥45 had longer survival
times and lower mortality rates than those with PNI <45 The survival time of patients with NRS 2002<3 points is longer than that of
patients with NRS 2002 ≥3 points and the mortality rate is lower than that of patients with NRS 2002≥3 points with statistical significance P<0. 05 . Conclusion The prognosis of lung cancer patients is influenced by TNM staging NRS 2002 score and PNI
score. By constructing a predictive model it is possible to timely understand the preoperative nutritional status of patients identify
high-risk states and carry out targeted interventions to improve prognosis.
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