Value Of Preoperative Prognostic Nutrition Index In Postoperative Survival Of Colorectal Cancer After Radical Resection

Objective:To explore the predictive value of the prognostic nutritional index(PNI)for the prognosis of patients after radical resection of colorectal cancer.Methods:The clinical data and follow-up data of 182 patients with colorectal cancer who underwent radical resection of colorectal cancer in the First Affiliated Hospital of Bengbu Medical College from January 2011 to January 2014 were retrospectively analyzed.Based on the neutrophil count,lymphocyte count,monocyte count and serum albumin concentration of the first blood collected before admission,calculate the preoperative PNI=serum albumin concentration(g/L)+ 5× lymphocyte count(× 109/L),NLR=neutrophil count÷lymphocyte count;LMR=lymphocyte count÷monocyte count.The receiver operating characteristic curve(ROC)curve was used to obtain the best cut-off values of PNI,NLR and LMR indicators.To analyze the relationship between preoperative PNI and clinicopathological data,use Kaplan-Meier to draw survival curves and use log-rank χ2 test to compare between groups,and use Cox proportional hazards model to conduct univariate and multivariate analysis of the correlation between preoperative PNI and patient prognosis Sex.Results:In 182 patients with colorectal cancer,the minimum preoperative PNI was 22.03,the maximum preoperative PNI was 71.06,and the average was47.62±9.88.The best cut-off value of the PNI value was 45.61.According to this cut-off value,the entire sample was divided into 67 cases.PNI group(<45.61)and 115 cases of high PNI group(≥45.61).K-M survival analysis showed that the 5-year survival rate of patients in the high PNI group was significantly higher than that of the low PNI group(χ2=19.706,P<0.001).The results of general clinical data analysis showed that preoperative PNI had nothing to do with gender(P=0.327),age(P=0.112),histological type(P=0.216),tumor location(P=0.575)and TNM stage(P=0.238).Preoperative PNI and body mass index BMI(P=0.021),tumor size(P=0.019),T stage(P=0.021),N stage(P<0.001),CEA(P=0.030),CA199(P=0.001),NLR(P=0.002)and LMR(P<0.001)are related.Univariate analysis showed that the patient’s age(P=0.001),T stage(P=0.036),N stage(P=0.001),PNI(P<0.001),NLR(P=0.040)and LMR(P=0.014)The5-year survival rate after colorectal cancer is related.Further analysis of the multivariate Cox model showed that the patient’s age(HR=1.977,95%CI: 1.204-3.246,P=0.007),T stage(HR=1.690,95%CI: 1.030-2.775,P=0.038),N Staging(HR=1.848,95%CI: 1.098-3.110,P=0.021)and PNI(HR=1.835,95%CI: 1.067-3.157,P=0.028)are independent risk factors affecting the survival of CRC.Conclusion:Preoperative PNI is clinically simple and easy to obtain.It is related to BMI,tumor size,T staging,N staging,CEA,CA199,NLR and LMR.It can better reflect the body’s nutritional and immune status,and is a radical resection of colorectal cancer.The independent risk factors for the 5-year survival rate of the patients after radical surgery have certain clinical application value for the prognosis assessment of patients after radical resection of colorectal cancer.