目的 探究卵巢癌化疗患者预后营养指数(PNI)与控制营养状态评分(CONUT)对患者化疗反应和生存期的影响。 方法 前瞻性选取 2017 年 1 月至 12 月在武汉市第三医院肿瘤科治疗且随访至 2022 年 12 月的卵巢癌患者 160 例作为研究对 象。 将 CONUT、PNI 的中重度营养不良的截断值作为依据,依据 CONUT 评分将患者分为低 CONUT 组(CONUT<5 分,n = 74) 与高 CONUT 组(CONUT≥5 分,n = 86)。 依据 PNI 将患者分为低 PNI 组(PNI<40,n = 78)与高 PNI 组(PNI≥40,n = 82)。 收集 不同组别患者总生存(OS)期情况,依据患者预后情况,使用 Kaplan-Meier 曲线评价患者整体生存情况并分析 CONUT、PNI 与 OS 的 关 系。 对 比 不 同 CONUT 及 PNI 化 疗 不 良 反 应 情 况。 结 果 160 例 卵 巢 癌 化 疗 患 者 中 位 随 访 时 间 为 33 个 月 (95%CI33. 694~ 36. 694),共 99 例(61. 88%)患者到达随访终点。 低 CONUT 组与高 CONUT 组患者中位 OS 期为 45 个月与 27 个月(χ 2 = 50. 283,P<0. 05),低 PNI 组与高 PNI 组患者的中位 OS 期分别为 27 个月与 44 个月( χ 2 = 9. 286,P< 0. 05)。 CONUT≥5 分或 PNI<40 的患者整体生存率较 CONUT<5 分及 PNI≥40 的患者低。 多因素 Cox 回归分析显示临床分期、糖类抗原 CA125、NLR、PLR、LMR 均为影响不同 CONUT、PNI 水平卵巢癌患者 OS 的独立影响因素(P<0. 05)。 低 CONUT 组患者白细胞 减少症、血小板减少症、恶心、呕吐及腹泻发生率均比高 CONUT 组患者低(P<0. 05)。 低 PNI 组患者恶心、呕吐及腹泻发生率 均比高 PNI 组患者高(P<0. 05)。 结论 CONUT、PNI 影响卵巢癌化疗患者 OS,且不同水平 CONUT、PNI 的患者出现的化疗不 良反应不一致,可见营养状态与卵巢癌化疗患者短期及长期预后的关联性显著,可作为预测患者化疗反应及预后的有效 指标。

Objective Exploring the effects of prognostic nutritional index PNI and control nutritional score CONUT on chemotherapy response and survival in ovarian cancer patients undergoing chemotherapy. Method A prospective study was conducted on 160 ovarian cancer patients who were treated at Wuhan Third Hospital from January 2017 to December 2017 and followed up until December 2022. Based on the cut-off value of moderate to severe malnutrition of CONUT and PNI patients were divided into low CONUT group CONUT<5 n = 74 and high CONUT group CONUT ≥ 5 n = 86 according to the CONUT score. Patients were divided into a low PNI group PNI<40 n = 78 and a high PNI group PNI ≥40 n = 82 based on PNI. Collect the overall survival OS of patients in different groups evaluate the overall survival of patients using Kaplan Meier curve based on their prognosis and analyze the relationship between CONUT PNI and OS. Compare the adverse reactions of different CONUT and PNI chemotherapy. Result The median follow - up time of 160 ovarian cancer chemotherapy patients was 33 months the 95% CI was 33. 694 36. 694 with a total of 99 patients 61. 88% reaching the follow-up endpoint. The median OS of patients in the low CONUT vs. high CONUT group was 45 months versus 27 months χ 2 = 50. 283 P<0. 05 respectively median OS for PNI <40 and PNI 40 was 27 months and 44 months respectively χ 2 = 9. 286 P<0. 05 . Patients with CONUT 5 or PNI <40 had lower overall survival than those with CONUT <5 and PNI 40. Cox regression showed that clinical stage CA125 NLR PLR and LMR were all independent factors affecting OS in ovarian cancer patients with different CONUT and PNI levels P < 0. 05 . The incidence of leukopenia thrombocytopenia nausea vomiting and diarrhea was higher in patients with low CONUT P<0. 05 . The incidence of nausea vomiting and diarrhea was higher in the low PNI group than in the PNI group P<0. 05 . Conclusion CONUT and PNI affect the OS of ovarian cancer patients with chemotherapy and the adverse effects of CONUT and PNI patients are inconsistent it can be seen that the association between nutritional status and the short-term and long-term prognosis of ovarian cancer chemotherapy patients is significant which can be used as an effective indicator to predict the chemotherapy response and prognosis of patients.