Prognostic significance of preoperative PNI and CA19-9 for pancreatic ductal adenocarcinoma: A multi-institutional retrospective study

被引：38

作者：

Itoh, Shinji ^{[1
]}

Tsujita, Eiji ^{[2
]}

Fukuzawa, Kengo ^{[3
]}

Sugimachi, Keishi ^{[4
]}

Iguchi, Tomohiri ^{[4
]}

Ninomiya, Mizuki ^{[5
]}

Maeda, Takashi ^{[6
]}

Kajiyama, Kiyashi ^{[7
]}

Adachi, Eisuke ^{[8
]}

Uchiyama, Hideaki ^{[9
]}

Utsunomiya, Tohru ^{[10
]}

Ikeda, Yasuharu ^{[11
]}

Maekawa, Soichirou ^{[12
]}

Toshima, Takeo ^{[1
]}

Harada, Noboru ^{[1
]}

Yoshizumi, Tomoharu ^{[1
]}

Mori, Masaki ^{[1
]}

机构：

[1] Kyushu Univ, Grad Sch Med Sci, Dept Surg & Sci, Fukuoka, Japan

[2] Fukuoka Higashi Med Ctr, Dept Surg, Fukuoka, Japan

[3] Oita Red Cross Hosp, Dept Surg, Oita, Japan

[4] Kyushu Canc Ctr, Dept Hepatobiliary Pancreat Surg, Fukuoka, Japan

[5] Matsuyama Red Cross Hosp, Dept Surg, Matsuyama, Ehime, Japan

[6] Hiroshima Red Cross Hosp & Atom Bomb Survivors Ho, Dept Surg, Hiroshima, Japan

[7] Iizuka Hosp, Dept Surg, Fukuoka, Japan

[8] Kyushu Cent Hosp, Dept Surg, Fukuoka, Japan

[9] Saiseikai Fukuoka Gen Hosp, Dept Surg, Fukuoka, Japan

[10] Oita Prefectural Hosp, Dept Surg, Oita, Japan

[11] Fukuoka City Hosp, Dept Surg, Fukuoka, Japan

[12] Munakata Med Assoc Hosp, Dept Surg, Fukuoka, Japan

来源：

PANCREATOLOGY | 2021年 / 21卷 / 07期

关键词：

Prognostic nutritional index; CA19-9; Pancreatic ductal adenocarcinoma; Prognosis; NUTRITIONAL RISK; PREDICTOR; IMPACT; INDEX;

D O I：

10.1016/j.pan.2021.08.003

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: The aim of this study was to investigate the clinical value of nutritional and immunological prognostic scores as predictors of outcomes and to identify the most promising scoring system for patients with pancreatic ductal adenocarcinoma (PDAC) in a multi-institutional study. Methods: Data were retrospectively collected for 589 patients who underwent surgical resection for PDAC. Prognostic analyses were performed for overall (OS) and recurrence-free survival (RFS) using tumor and patient-related factors, namely neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, Prognostic Nutritional Index (PNI), Glasgow Prognostic Score (GPS), modified GPS, C-reactive protein-toalbumin ratio, Controlling Nutritional Status score, and the Geriatric Nutritional Risk Index. Results: Compared with PDAC patients with high PNI values (>46), low PNI (<46) patients showed significantly worse overall survival (OS) (multivariate hazard ratio (HR), 1.432; 95% CI, 1.069-1.918; p = 0.0161) and RFS (multivariate HR, 1.339; 95% CI, 1.032-1.736; p = 0.0277). High carbohydrate antigen 19-9 (CA19-9) values (>450) were significantly correlated with shorter OS (multivariate HR, 1.520; 95% CI, 1.261-2.080; p = 0.0002) and RFS (multivariate HR, 1.533; 95% CI, 1.199-1.961; p = 0.0007). Stratification according to PNI and CA19-9 was also significantly associated with OS and RFS (log rank, P < 0.0001). Conclusions: Our large cohort study showed that PNI and CA19-9 were associated with poor clinical outcomes in PDAC patients following surgical resection. Additionally, combining PNI with CA19-9 enabled further classification of patients according to their clinical outcomes. (c) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

引用

页码：1356 / 1363

页数：8

共 23 条

[1] Prognostic Value of Preoperative Nutritional and Immunological Factors in Patients with Pancreatic Ductal Adenocarcinoma [J].