术前PNI与IB1~IIA2期宫颈癌临床病理特征及PLNM的意义

Significance of Preoperative PNI in Clinicopathological Characteristics and PLNM of Stage IB1~IIA2 Cervical Cancer

摘要: 目的：评估术前预后营养指数(prognostic nutritional index, PNI)与IB1~IIA2期宫颈癌(cervical cancer)临床病理特征的关系，以及评估盆腔淋巴结转移(pelvic lymphnode metastasis, PLNM)的意义。方法：采集2018年12月~2020年6月于青岛大学附属医院接受初始治疗方式为根治性子宫切除术及盆腔淋巴结切除术的101例IB1~IIA2期宫颈癌患者的检验结果及病理报告。采用受试者工作特征(ROC)曲线分析PNI预测IB1~IIA2期宫颈癌盆腔淋巴结转移的最佳临界值。统计学比较PLNM阴性和阳性组患者的临床病理特征，采用单因素、多因素logistic分析可能影响IB1~IIA2期宫颈癌PLNM的因素。结果：101例IB1~IIA2期宫颈癌中，PLNM阳性和阴性患者分别为31例和70例。依据ROC曲线，PNI预测IB1~IIA2期宫颈癌PLNM的最佳临界值为52.2，其中PNI ≤ 52.2者44例，PNI > 52.2者57例。单因素、多因素logistic回归分析均证明，PNI是预测IB1~IIA2期宫颈癌PLNM的指标(P < 0.05)。结论：术前外周血PNI是IB1~IIA2期PLNM的独立预测指标。

Abstract: Objective: To evaluate the significance of preoperative prognostic nutritional index (PNI) with clinicopathological features and pelvic lymphnode metastasis (PLNM) in stage IB1~IIA2 cervical cancer. Methods: From December 2018 to June 2020, 101 patients with stage IB1~IIA2 cervical cancer who underwent radical surgery in the Affiliated Hospital of Qingdao University were collected. Receiver operating characteristic (ROC) curve was used to analyze the optimal cut-off value of PNI in predicting PLNM of stage IB1~IIA2 cervical cancer. The clinicopathological characteristics of patients with PLNM negative and positive groups were compared statistically. Univariate and multivariate logistic analysis was used to analyze the factors that may affect PLNM in stage IB1~IIA2 cervical cancer. Results: In 101 cases of IB1~IIA2 cervical cancer, 31 cases were PLNM positive and 70 cases were negative. According to the ROC curve, the best cut-off value of PNI in predicting PLNM of stage IB1~IIA2 cervical cancer was 52.2, of which 44 cases were PNI ≤ 52.2, and 57 cases were PNI > 52.2. Univariate and multivariate logistic regression analysis showed that PNI was a predictor of PLNM in stage IB1~IIA2 cervical cancer (P < 0.10). Conclusion: Preoperative peripheral blood PNI is an independent predictor of PLNM in stage IB1~IIA2 cervical cancer.