Clinical significance of prognostic nutritional index in renal cell carcinomas.
Prognostic nutritional index (PNI) could reflect the nutrition and inflammation status in cancer patients. This study aims to identify the prognostic significance of PNI in patients with renal cell carcinoma (RCC).A total of 694 RCC patients from our institution were included in this study. The prognostic correlation between PNI and overall survival (OS) and recurrence-free survival (RFS) was analyzed respectively using Kaplan-Meier method and univariate and multivariate Cox model. Studies about the association between pretreatment or preoperative PNI and prognosis of RCC were systemically reviewed and a meta-analysis method was performed to further evaluate the pooled prognostic value of PNI in RCC.267 (38.47%) RCC patients had low PNI according to the cut off value (49.08). Low PNI was associated with poor OS (P < .001) and RFS (P < .001), respectively. In the multivariate Cox analysis, PNI was identified to be an independent prognostic factor for OS (hazard ratio [HR] = 2.13, 95%CI: 1.25-3.62, P = .005). Compared to other nutritional indexes, this risk correlation of PNI is better than that of geriatric nutritional risk index (GNRI; HR = 1.19; P = .531), while is no better than that of neutrophil-lymphocyte ratio (NLR; 1/HR = 2.56; P < .001) and platelet-lymphocyte ratio (PLR; 1/HR = 2.85; P < .001) respectively. Meanwhile, additional 4785 patients from 6 studies were included into pooled analysis. For RCC patients who underwent surgery, low preoperative PNI was significantly associated with worse OS (pooled HR = 1.57, 95%CI: 1.37-1.80, P < .001) and worse RFS (pooled HR = 1.69, 95%CI: 1.45-1.96, P < .001). Furthermore, low PNI (<41-51) was also significantly associated with poor OS (HR = 1.78, 95%CI: 1.26-2.53 P < .05) and poor RFS (HR = 2.03, 95%CI: 1.40-2.95, P < .05) in advanced cases treated with targeted therapies.The present evidences show that PNI is an independent prognostic factor in RCC. Low PNI is significant associated with poor prognosis of RCC patients.
Tang Y
，Liang J
，Liu Z
，Zhang R
，Zou Z
，Wu K
，Lu Y
，Wei X
... -
《-》
Utility of prognostic nutritional index and systemic immune-inflammation index in oral cancer treatment.
This study aimed to evaluate the utility of inflammation-based prognostic scores (IBPS) and systemic immune-inflammation index (SII) in the treatment of oral cancer patients.
For the 183 patients enrolled in this study, IBPS and SII were calculated from peripheral blood samples obtained before and after treatment and at the time of relapse. We examined overall survival (OS) and disease-free survival (DFS) using previously reported cut-off values for IBPS. Cut-off values of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were analyzed as NLR 1.79, PLR 114.97, LMR 5, and PNI 52.44. The cut-off value for SII was set at 569. OS and DFS were analyzed by Kaplan-Meier methods using the cutoff of each IBPS and SII. Univariate analysis and multivariate analysis using Cox proportional hazards were performed for OS and DFS.
Kaplan-Meier methods showed the high-PNI group showed good prognosis including OS and DFS, while the high-SII group displayed poor DFS. Univariate analysis showed that pre-treatment high PNI and low SII were significantly associated with better prognosis. Multivariate analysis identified pre-treatment PNI as independently associated with OS. For DFS, univariate analysis using Cox proportional hazards modeling showed that pre-treatment high NLR and high SII were significantly associated with worse prognosis, while high PNI was significantly associated with better prognosis. Multivariate analysis identified pre-treatment PNI and SII as independently associated with DFS. Parameters of PNI and SII components were compared between pre-treatment, post-treatment and at relapse in the high- and low-PNI groups. PNI was predominantly decreased in both high- and low-PNI groups at post-treatment and at relapse compared to pre-treatment. This trend was also observed for albumin.
Higher pre-treatment PNI was associated with better OS, while lower pre-treatment PNI and higher treatment SII were associated with poorer DFS in oral cancer patients. Our data indicated that PNI and SII might offer useful biomarkers for gauging prognosis and the efficacy of conventional therapies.
Kubota K
，Ito R
，Narita N
，Tanaka Y
，Furudate K
，Akiyama N
，Chih CH
，Komatsu S
，Kobayashi W
... -
《BMC CANCER》
Multicenter Study of Controlling Nutritional Status (CONUT) Score as a Prognostic Factor in Patients With HIV-Related Renal Cell Carcinoma.
In recent years, the controlled nutritional status (CONUT) score has been widely recognized as a new indicator for assessing survival in patients with urological neoplasms, including renal, ureteral, and bladder cancer. However, the CONUT score has not been analyzed in patients with HIV-related urological neoplasms. Therefore, we aimed to evaluate the prognostic significance of the CONUT score in patients with HIV-related renal cell carcinoma (RCC).
A total of 106 patients with HIV-related RCC were recruited from four hospitals between 2012 and 2021, and all included patients received radical nephrectomy or partial nephrectomy. The CONUT score was calculated by serum albumin, total lymphocyte counts, and total cholesterol concentrations. Patients with RCC were divided into two groups according to the optimal cutoff value of the CONUT score. Survival analysis of different CONUT groups was performed by the Kaplan-Meier method and a log rank test. A Cox proportional risk model was used to test for correlations between clinical variables and cancer-specific survival (CSS), overall survival (OS), and disease-free survival (DFS). Clinical variables included age, sex, hypertension, diabetes, tumor grade, Fuhrman grade, histology, surgery, and CD4+ T lymphocyte count.
The median age was 51 years, with 93 males and 13 females. At a median follow-up of 41 months, 25 patients (23.6%) had died or had tumor recurrence and metastasis. The optimal cutoff value for the CONUT score was 3, and a lower CONUT score was associated with the Fuhrman grade (P=0.024). Patients with lower CONUT scores had better CSS (HR 0.197, 95% CI 0.077-0.502, P=0.001), OS (HR 0.177, 95% CI 0.070-0.446, P<0.001) and DFS (HR 0.176, 95% CI 0.070-0.444, P<0.001). Multivariate Cox regression analysis indicated that a low CONUT score was an independent predictor of CSS, OS and DFS (CSS: HR=0.225, 95% CI 0.067-0.749, P=0.015; OS: HR=0.201, 95% CI 0.061-0.661, P=0.008; DFS: HR=0.227, 95% CI 0.078-0.664, P=0.007). In addition, a low Fuhrman grade was an independent predictor of CSS (HR 0.192, 95% CI 0.045-0.810, P=0.025), OS (HR 0.203, 95% CI 0.049-0.842, P=0.028), and DFS (HR 0.180, 95% CI 0.048-0.669, P=0.010), while other factors, such as age, sex, hypertension, diabetes, tumor grade, histology, surgery, and CD4+ T lymphocyte count, were not associated with survival outcome.
The CONUT score, an easily measurable immune-nutritional biomarker, may provide useful prognostic information in HIV-related RCC.
Xue W
，Zhang Y
，Wang H
，Zhang Y
，Hu X
... -
《Frontiers in Immunology》
The Relationship Between Preoperative Systemic Immune Inflammation Index and Prognostic Nutritional Index and the Prognosis of Patients With Alveolar Hydatid Disease.
To explore the relationship between the preoperative immune inflammation index (SII) and the prognostic nutritional index (PNI) and the overall survival rate (OS) of patients with alveolar hydatid disease.
The clinical data of patients with hepatic alveolar echinococcosis treated by surgery in the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University from January 2015 to January 2019 were analyzed retrospectively, and the SII, PNI, PLR and NLR were calculated. Spearman correlation analysis was utilized to analyze the correlation among SII, PNI, PLR and NLR. Receiver operating characteristic curve (ROC) was utilized to determine the best intercept values of SII, PNI, PLR and NLR, and Chi-square test was used to evaluate the relationship between SII, PNI and various clinicopathological features in patients with hepatic alveolar echinococcosis. The kaplan-Meier method was used to draw survival curves and analyze the relationship between them and the total survival time of patients. A cox regression model was used to analyze the relationship between SII, PNI and the prognosis of patients with hepatic alveolar echinococcosis. Finally, ROC curve was used to estimate the predictive efficacy of SII, PNI and COSII-PNI for the prognosis of patients with hepatic alveolar echinococcosis.
A total of 242 patients were included, including 96 males and 146 females, aged 11.0-67.0 (36.6 ± 11.7) years. The values of SII, PNI, PLR and NLR are calculated, and the best truncation values of SII, PNI, PLR and NLR are given in ROC curve. The kaplan-Meier survival curve was used to analyze the relationship between SII, PNI, PLR, NLR and the overall survival time of patients with hepatic alveolar echinococcosis. The results showed that the median follow-up time was 45 months (95%CI: 39.484-50.516), and the average survival time was 49 months (95%CI: 47.300-51.931), which was low p<0.001); The 5-year OS rate of low PNI was significantly lower than that of high PNI group (37.7% vs 71.6%; p<0.001); The 5-year OS rate in low PLR group was significantly higher than that in high PLR group (70.4% vs 24.3%; p<0.001); The 5-year OS rate in low NLR group was significantly higher than that in high NLR group (67.2% vs 28.8%; p<0.001). Cox unifoliate analysis showed that SII, PNI, PLR and NLR were important prognostic factors related to OS. Cox multivariate analysis showed that SII(HR=4.678, 95% CI: 2.581-8.480, P<0.001) and PNI(HR=0.530, 95%CI: 0.305-0.920, P<0.05) were identified as independent risk indicators of OS, while NL was identified as independent risk indicators of OS ROC curve analysis showed that AUC of SII, PNI, PLR, NLR and COSII-PNI were 0.670(95%CI: 0.601-0.738), 0.638(95%CI: 0.561-0.716) and 0.618(95% CI: 0.541-0.694), respectively COSII-PNI is superior to SII and PNI in evaluating prognosis (P < 0.05).
SII and PNI can be regarded as independent risk factors reflecting the prognosis of patients with hepatic alveolar echinococcosis. The lower SII and the higher PNI before operation, the better the prognosis of patients, and the combined application of SII and PNI before operation can improve the accuracy of prediction.
Ren B
，Chen X
，Lei P
，Hou L
，Wang H
，Zhou Y
，Ren L
，Fan H
，Wang Z
，Yuan J
... -
《Frontiers in Immunology》
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