目的 探讨了预后营养指数(PNI)对转移性胰腺癌患者预后及一线化疗疗效的预测价值。 方法 回顾性分析 2017 年 4 月至 2022 年 2 月武汉大学中南医院肿瘤放化疗科接受一线化疗的 83 例转移性胰腺癌患者的临床资料及随访资料,计算 PNI 值;根据受试者操作特征曲线(ROC 曲线)确定 PNI 预测转移性胰腺癌患者总生存(OS)的最佳截止点;根据最佳截止点 将患者分为低 PNI 组(34 例)与高 PNI 组(49 例);采用 Cox 比例风险回归模型及 Kaplan-Meier 曲线研究 PNI 对于转移性胰腺 癌患者生存的预测价值。 结果 根据 ROC 曲线,确定 PNI 最佳截止点为 43. 10。 PNI 与转移性胰腺癌患者一线化疗的客观缓 解率、无进展生存时间(mPFS) 及 OS 显著相关。 全组患者的 mPFS 和中位总生存时间( mOS) 分别为 4. 61( 95%CI = 3. 92 ~ 5. 30)和 9. 05(95% CI = 8. 20~ 9. 89)个月。 低 PNI 组与高 PNI 组的转移性胰腺癌患者一线化疗客观缓解率分别为 5. 9%和 32. 7%(P<0. 05)。 低 PNI 组与高 PNI 组的患者 mPFS 分别为 2. 96 个月(95%CI = 2. 53 ~ 3. 47)与 5. 67 个月(95%CI = 4. 43 ~ 6. 21),两组间具有显著差异(P<0. 01)。 同时,低 PNI 组与高 PNI 组的患者 mOS 分别为 5. 92 个月(95%CI = 5. 30 ~ 6. 55)与 11. 84 个月(95%CI = 9. 10~ 14. 59),两组间同样具有显著差异(P<0. 01)。 多因素 Cox 回归分析结果显示,PNI(HR = 0. 123, 95%CI = 0. 061~ 0. 248,P<0. 01)是转移性胰腺癌患者 OS 的独立预后因素。 结论 PNI 可作为转移性胰腺癌患者一线化疗疗效 和生存的预后因素。

Objective We aim to investigate the clinical value of prognostic nutritional index PNI in evaluating the prognosis of patients with metastatic pancreatic cancer. Method Clinical data and follow-up data of 83 patients with metastatic pancreatic cancer undergoing first-line chemotherapy from April 2017 to February 2022 in Zhongnan Hospital of Wuhan University were retrospectively collected and analyzed. PNI value was calculated and the optimal cut-off point of PNI was determined using the receiver operation characteristics ROC curve. Cox univariate and multivariate regression analysis and Kaplan-Meier curve were performed to evaluate the prognostic value of PNI for metastatic pancreatic cancer patients. Result According to the ROC curve analysis the optimal cut-off point of PNI was 43. 10. PNI was significantly correlated with objective response rate ORR progression free survival PFS and overall survival OS of patients with metastatic pancreatic cancer receiving first-line chemotherapy. The median PFS and median OS were 4. 61 95%CI = 3. 92-5. 30 and 9. 05 95%CI = 8. 20-9. 89 months respectively. The ORR in low PNI group and high PNI group was 5. 9% and 32. 7% respectively P<0. 05 . The median progression free survival time mPFS of patients in low PNI group and high PNI group were 2. 96 months 95%CI = 2. 53-3. 47 and 5. 67 months 95%CI = 4. 43-6. 21 respectively. There was a significant difference between the two groups P<0. 01 . Meanwhile the median overall survival time mOS of patients in the low PNI group and the high PNI group was 5. 92 months 95% CI = 5. 30 - 6. 55 and 11. 84 months 95% CI = 9. 10 - 14. 59 respectively. There was also a significant difference between the two groups P<0. 01 . Multivariate Cox regression analysis showed that PNI HR = 0. 123 95% CI = 0. 061- 0. 248 P< 0. 01 was an independent prognostic factor of OS in patients with metastatic pancreatic cancer. Conclusion PNI can be used as a prognostic factor for patients with metastatic pancreatic cancer.