Prognostic Significance Of Pni In Patients With Pancreatic Head Tumor Undergoing Laparoscopic Pancreaticoduodenectomy

Objective:To investigate the prognostic value of nutritional index in predicting the prognosis of patients with pancreatic head tumor after laparoscopic pancreaticoduodenectomy.Methods:From February 11,2018 to November 8,2021,two hundred and fifty-one pancreatic head carcinoma patients were retrospectively enrolled.The receiver operator characteristic(ROC)curve was used to determine the cut-off value.Patients were divided into two groups: PNI > 45.1(high PNI group)and PNI < 45.1(low PNI group),and clinic-pathological data was compared between the two groups.The link between PNI and neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),and plated-to-lymphocyte ratio(PLR),and their effect on overall survival.In addition,the factors of postoperative survival were analyzed univariate and multivariate.Results:PNI,NLR,PLR and LMR cut-off values were 45.1,3.7,287.2 and 3.6,respectively.Between the two groups of patients,the low PNI group exhibited considerably higher PLR and lower LMR.PNI had a negative correlation with PLR and NLR(r =-0.329,p < 0.001 and r = 0.170,p = 0.014),but a positive correlation with LMR(r = 0.476,p< 0.001).The high PNI group had a considerably greater survival rate than the low PNI group(median survival days,217 vs.468,log-rank = 45.92,p < 0.001).PNI < 45.1(HR:0.357,95 percent CI,0.263–0.485,p < 0.001)and LMR <3.6(HR: 0.705,95 percent CI,0.528–0.942,p < 0.018)were revealed to be possible predictive variable in univariate analysis.Only PNI <45.1 was found to be an independent predictive factor in multivariate analysis(HR: 0.359,95%CI:0.256–0.502,p < 0.001).Conclusions:Our findings show that PNI is linked to a variety of systemic inflammatory response and can be used as the prognostic survival predictors in the PLD individuals with pancreatic head tumor.