| ObjectivePrognostic nutritional index,which is short for PNI,is a kind of nutrition evaluation index,which can reflect the nutritional status of patients.In the early days,it was mainly used to evaluate the surgical preoperative nutritional status,the risk of surgery and postoperative complications.However,in recent years,many studies at home and abroad have put PNI as a new index for evaluating the prognosis of many kinds of malignant tumor patients,such as esophageal cancer,liver cancer,colorectal cancer,pancreatic cancer,gastric cancer ect.Using survival analysis to analyse the clinical data and follow-up data of 123 cases of locally advanced non-small cell lung cancer,and by studying the effect of prognostic nutritional index predicting overall survival in patients,the experiment is preliminary to discuss the clinical application value of PNI in evaluating the prognosis of patients with locally advanced non-small cell lung cancer.MethodsOne hundred and forty five cases of locally advanced NSCLC patients of this study were selected from respiratory medicine ward of Shandong province Qianfoshan hospital from May 1,2005 to January1,2015,who were successfully diagnosed by pathological for the first time.According to the inclusion criteria and exclusion criteria,finally 123 patients with NSCLC were enrolled in this experiment.Clinical data for evaluating the prognosis factors were collected from the electronic medical records of selected patients retrosp ectively,such as age,sex,smoking,whether to reduce weight,transfer,organi zation type,clinical stage,the type of treatment,the serum albumin level and the total number of lymphocytes within 1 week before treatment,etc.And the PNI was calculated as 10*serum albumin value(g/L)+5*total lymphocyte count(*10^9/L)in peripheral blood.The OS of patients was from the histopathologic diagnosis to the date on the day of death or the end of follow-up.All patients were performed at the end of the telephone follow-up to death or lost to follow-up or follow-up to end date on May 1,2015.All data adopt SPSS19.0statistical software for processing,the continuity of the variables are indicated by mean plus standard deviation if they accord with normal distribution,t test or F test are adopted for the comparison between the means,and counting data are tested by chi-square test.Application of Kaplan Meier method to calculate the survival curve,the comparison of differences was tested by the log-rank test;A variety of potential prognostic factors influence on OS are analysed by Cox risk model for multiple factors,difference is statistically significant(P<0.05).Results1.The median age of 123 cases of patients with NSCLC was 64 years old,the percentage of men was 63.4% and the percentage of women was 36.6%,the sex ratio was 1.73:1,and the smoking patients accounted for 57% of NSCLC patients.The clinical symptoms of NSCLC patients:the percentage of hemoptysis was 32.6%,the chest pain was 20.4%,the dyspnea was 18.7% and the weight loss patients accounted for 36.6%.The primary site of NSCLC in left lung accounted for 47.96%,while in the right lung was 46.34%,and other parts accounted for 5.70%.The histopathologic types:the percentage of lung squamous cell carcinomas was 30.08%,the percentage of lung adenocarcinoma was 63.41%,and the percentage of other types was 6.51%.In the TNM staging,? stage patients accounted for 25.20%,while the percentage of ?stage patients was 74.80%.2.The relationship of PNI values with clinical data:the mean of PNI was 46.24(sd6.56),and the PNI was closely related to the patient's age,weight loss and pleural effusion,and the differences between them are significant(P<0.05).While the results states that PNI has no obvious correlation to the patient's gender,smoking,hemoptysis,chest pain,dyspnea,histological type,clinical stage,tumor primary site or whether chemotherapy,and the differences of them were no statistically significant(P>0.05).3.Single factor analysis showed that:the OS of locally advanced NSCLC in low PNI,age 64 or higher,dyspnea,body weight loss,were shorter than age 64 or lower,no difficulty breathing,no weight loss,and the differences were statistically significant(P<0.05).4.Mul-tivariate analysis of COX model showed that the patients of low PNI group(P<46.24)were more risk of death than the patients of higher PNI group(P? 46.24)(hazard ratio2.758,95%confidence interval1.672-4.594,P=0.000).While the age,dyspnea,weight loss are not independent risk factors for the advanced non-small cell lung cancer.Conclusions1.In locally advanced NSCLC,low PNI,age 64 or higher,difficulty breathing,and weight loss are the influence factors of OS time in the patients of small cell lung cancer.2.Survival analysis showed that PNI is an independent risk factor in advanced nonsmall cell lung cancer,and the calculation of PNI is simple,it is a relatively new evaluation index of prognosis on advanced non-small cell lung cancer,and has a certain clinical application value. |
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