目的 探讨预后营养指数(PNI)对呋喹替尼三线治疗晚期结直肠癌患者疗效的预后分析。 方法 选取 2017 年 11 月至 2020 年 6 月华中科技大学同济医学院附属同济医院肿瘤中心消化肿瘤科及荆州市中心医院肿瘤科收治并接受呋喹替尼 三线治疗的晚期结直肠癌患者 33 例,计算 PNI、中性粒细胞/ 淋巴细胞比值(NLR)、血小板/ 淋巴细胞比值(PLR)以及淋巴细 胞/ 单核细胞比值(LMR)等营养免疫评估指标。 采用 Cox 比例风险回归模型(简称 Cox 回归)及 Kaplan-Meier 曲线 Log-rank 检验评价相关免疫营养指标对于患者生存的影响。 结果 根据总生存(OS)期的受试者操作特征曲线(ROC 曲线)分析,PNI 最佳截止点为 46. 95;单因素 Cox 回归分析结果显示,PNI、NLR 及 LMR 是 OS 的影响因素,多变量 Cox 分析显示 PNI 是 OS 期 的独立预后因素。 低 PNI 患者 1 年生存率为 9. 894%(95%CI = 8. 300~ 23. 566),中位总生存(mOS)期为 6. 700 个月(95%CI = 5. 524~ 7. 876),高 PNI 患者 1 年生存率是 42. 218%(95%CI = 22. 496 ~ 46. 378,P<0. 05),mOS 期为 11. 400 个月(95%CI = 6. 123~ 16. 677,P<0. 05); PNI 低的患者中位无进展生存(mPFS)期为 2. 200 个月(95%CI = 1. 278 ~ 3. 122);PNI 高的患者 mPFS 期为 3. 067 个月(95%CI = 1. 095~ 5. 039,P>0. 05)。 结论 PNI 可作为呋喹替尼三线治疗晚期结直肠癌患者的生存预后因素。

Objective To investigate the prognostic value of prognostic nutritional index PNI in the advanced colorectal cancer patients who received the fruquintinib as third-line therapy. Method From November 2017 to June 2020 33 patients with advanced colorectal cancer were selected from Jingzhou Central Hospital and Tongji Hospital Cancer Tongji Medical College Affiliated Huazhong University of Science and Technology. PNI prognostic nutritional index PLR platelet lymphocyte ratio and LMR lymphocyte monocyte ratio were calculated. Cox proportional hazards regression models and Kaplan-Meier curve and Log rank test were used to evaluate the impact on survival. Result According to receiver operating characteristic ROC curves the cut-off value for PNI was 46. 95. The result of univariate analysis showed that PNI HGB NLR and LMR were significantly correlated with overall survival OS . Multivariate analysis showed the PNI was independent prognostic factor of OS. The one-year survival rate and the median overall survival for PNIlow patients were 9. 894% 95%CI = 8. 300-23. 566 and 6. 700 months 95%CI = 5. 524-7. 876 while the one-year survival rate and the mOS for the PNI-high patients were 42. 218% 95%CI = 22. 496-46. 378 P<0. 05 and 11. 400 months 95%CI = 6. 123-16. 677 P<0. 05 . The median progression free survival mPFS for PNI-low and PNI-high patients were 2. 200 months 95%CI = 1. 278- 3. 122 and 3. 067 months 95%CI = 1. 095-5. 039 P>0. 05 . Conclusion PNI could be a useful prognostic indicator for advanced colorectal cancer patients who received the fruquintinib as third line treatment.