| Objective: The goal of this study was to investigate the relationship between prognostic nutritional index(PNI)and overall survival(OS).We also identify the risk factors affecting overall survival(OS)and explore whether PNI could be used as an independent prognostic predictor for PC patients after surgical resection.Method: Between November 2008 and January 2015,55 PC patients undergoing surgical resection in the Second Affiliated Hospital of Dalian Medical University were enrolled in this study.The PNI was calculated according to the following formula: serum albumin(g/L)+ 5×total lymphocyte count(109/L).Among the 55 patients enrolled in the study,we divided them into two groups according to the PNI<47.3 or PNI≥47.3.Student’s t test and Chi-square test were used to analyze the clinical data and Fisher probabilities was used if necessary between two groups.Kaplane-Meier method was used to compare OS in two groups and the log-rank test was applied to estimate differences in survival.Univariate and multivariate analysis were accomplished using the Cox proportional hazards regression model in the Statistical Package for Social Sciences version 19.0(SPSS).P<0.05 was considered statistically significant.Result: In 55 patients enrolled in the study,male patients account for 69%(38/55)and the female patients occupied 31%(38/55).Age less than 61 years old was 44%(24/55)and the left was 56%(31/55).PNI correlated negatively with systemic inflammatory response markers NLR(Spearman correlation=-0.409,P=0.002)and PLR(Spearman correlation=-0.349,P=0.01)and positively with LMR(Spearman correlation=0.330,P=0.015).Among the 55 patients,we divided them into two groups according to the PNI<47.3 or PNI≥47.3.In the two groups,gender(male/female),age(<61/≥61),ALB(<35g/L/≥35g/L),total bilirubin(TB)(<20umol/L/≥20umol/L),direct bilirubin(DB)(<6umol/L/≥6umol/L),total bile acid(TBA)(< 10umol/L/≥10umol/L),LDH(<226U/L/≥226U/L),glucose(GLU)(< 6.1mmol/L/≥6.1mmol/L),GGT(<47.3U/L/≥47.3U/L),alkaline phosphatase(ALP)(< 135U/L/≥135U/L),operation duration(< 362min/≥362min),neutrophil/lymphocyte ratio(NLR)(< 3.4/≥3.4),platelet/lymphocyte ratio(PLR)(<190/≥190),lymphocyte/monocyte ratio(LMR)(<4.28/≥4.28),differentiation,cancer stage(ⅠⅡⅢ)had no statistical differences(P>0.05).1-year OS of 55 patients was 43.6%(42 weeks).1-year OS of the group(PNI<47.3)was 37%(30 weeks)and the other 1-year OS(PNI≥47.3)was 50%(46 weeks).According to the Kaplane-Meier method,1-year OS had statistical differences(log-rank,P=0.041)between the two groups(PNI<47.3/ PNI≥47.3).Univariate analysis using Cox proportional hazards regression implied gender(male/female),age(<61/≥61),ALB(<35g/L/≥35g/L),TB(<20umol/L/≥20umol/L),DB(<6umol/L/≥6umol/L),TBA(<10umol/L/≥10umol/L),LDH(<226U/L/≥226U/L),GLU(< 6.1mmol/L/≥6.1mmol/L),GGT(< 47.3U/L/≥47.3U/L),ALP(<135U/L/≥135U/L),operation duration(<362min/≥362min),differentiation,cancer stage(ⅠⅡⅢ)made no difference to 1-year OS.On the contrary,PNI(<47.3/≥47.3)made a difference to 1-year OS and hazard ratio(HR)was 0.964.Multivariate analysis using Cox proportional hazards regression showed that PNI(<47.3/≥47.3)made a difference to 1-year OS and HR was 0.987(95% CI,0.828-1.106).Consequently this study confirmed PNI as an independent prognostic predictor for 1-year OS.Conclusion: Prognostic nutritional index(PNI)could be used as an independent prognostic predictor for 1-year overall survival(OS)of pancreatic cancer(PC)patients. |
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