Clinical Value Of PNI And HGB In Evaluating The Prognosis Of Middle To Late Stage Non-small Cell Lung Cancer Patients

BACKGROUDIn recent years,the incidence of lung cancer raised gradually word-wide,including our country.At present,it has become the highest morbidity and mortality malignant tumor.Of which non-small cell lung cancer(NSCLC)accounts for about 80%.Most of the patients are already in the middle to late stage of the disease when they are diagnosed.At that time,they losed opportunities or the optimal time of surgery operation.The treatment of middle to late stage non-small cell lung cancer mainly are comprehensive treatments based on chemical treatment,targeted therapy and radiotherapy.The overall survival state are still not optimistic at present.In recent years,more and more research have conducted to explore the the factors influencing prognosis of lung cancer patients.However,there are still lack of biological indicators of prognosis with high sensitivity and specificity.Resent studies showed that patient’s immune status have important influence on prognosis of all kinds of tumor patients.Prognosis of nutrition index(PNI)have been confirmed can be used as a prognostic indicator for a variety of malignant tumors.Meanwhile,Anemia have been proved can be used as an independent prognostic indicator for cancer patients underwent surgery,chemotherapy or radiotherapy.However,There are less research in patients with non-small cell lung cancer both PNI and anemia.In this study,we explore the clinical value of PNI and the moglobin(HGB)in evaluating the prognosis of middle to late stage non-small cell lung cancer patients by using the method of retrospective study.OBJECTIVEThis study adopts the method of retrospective study.We assessment the impact of PNI and HGB when they were first diagnosed with middle-late non-small cell lung cancer on patients’s overal survival(OS).On this basis,we explore the clinical value of PNI and HGB in evaluating the prognosis of middle to late stage non-small cell lung cancer patients.Looking forward to the research results can provide some reference and guidance for clinical diagnosis and treatment work.METHODSThe eligiblelocally 120 cases of middle to late stage non-small cell lung cancer patients were all confirmed for the first time in respiratory physicians of qianfoshan hospital from August 2013 to August 2015.They were all confirmed by histopathological diagnosis methods.All the patients in this study were strictly filtrated by the inclusion criteria and exclusion criteria.The clinical information and data of all the patients were collected when they were first confirmed.The data including gender,age,clinical stage,histological type,whether they have dyspnea or pleural effusion,smoking index,weight loss rate nearly three months,serum albumin(ALB),peripheral blood lymphocyte count(LYMP),peripheral blood HGB,etc.All the patients were followed-up and recorded by the date of death or August 2016 through electronic medical record system,outpatient and telephone,etc.The patients were divided into high PNI group,low PNI group and high HGB group,low HGB group on the basis of the median of PNI(46.52)and HGB(115g/L).We applied SPSS 19.0 statistical software for statistical analysis.The impact of PNI and HGB when they were first diagnosed on patient’s OS were analyzed through single factor and multiple factors methods.The survival curves of two group patients were produced by Kaplan-Meier method.At the same time,the Log-rank test were exerted.The related influencing factors of PNI and HGB were analyzed through single factor method.P<0.05 showed statistically significant difference.RESUITS1.The impact of each variate on patient’s OS were analyzed through log-rank single factor analysis.The results showed that the patient’s OS who>65 years of age,smoking index≥400 were significantly lower than the patient’s OS who<65years of age,smoking index<400(P<0.05).The high PNI group patient’s OS were significantly higher than the low PNI group patient’s OS,P=0.000.The high HGB group patient’s OS were significantly higher than the low HGB group patient’s OS,P＝0.000.However,The impact of patient’s gender,clinical stage,histological type,pleural effusion,dyspnea,treatment on patient’s OS have no statistically significant.2.One the bases of the results through log-rank single factor analysis,that is PNI,HGB,age,smoking index all have statistically significant impact on patient’s OS.We brought that four indicators into further multiple factors analyse through cox’s regression model.The result showed that only PNI and HGB have statistically significant impact on patient’s OS.P respectively were 0.000 and 0.001.Meanwhile,Exp(B)respectively were 2.180 and 2.032.The result showed that patient’s PNI and HGB were all independent risk factors for patient’s OS.The impact of patient’s age,smoking index on OS have no statistically significant(P>0.05).3.The relationship of PNI and HGB between each variate were analysed through ANOVA model single factor method.The result showed that the medium PNI were closely related to the age,clinical stage,pleural effusion,smoking index of the patients.P respectively were 0.024,0.017,0.016,0.007.The medium HGB were closely related to the age,weight loss rate of the patients.P respectively were 0.025,0.008.CONCLUSIONS1.The PNI,HGB,age,smoking index of the middle-late non small lung cancer patients when they were first confirmed have significant impact on their OS.2.The PNI and HGB of the middle-late non small lung cancer patients when they were first confirmed were independent risk factors for their prognosis.3.The medium PNI were closely related to the age,clinical stage,pleural effusion,smoking index of the patients.The medium HGB were closely related to the age,weight loss rate of the patients.