Correlation of Prognostic Nutritional Index with Overall Survival of Postoperative Patients with Thymoma
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摘要:目的
探讨预后营养指数（PNI）与胸腺瘤术后患者总生存率的相关性。
方法回顾性分析173例胸腺瘤术后患者的临床病理资料。
结果手术是否R0切除（P < 0.001）、是否合并重症肌无力（P < 0.001）、Masaoka分期（Ⅱ/Ⅰ: P=0.012; Ⅲ & Ⅳ/Ⅰ: P=0.011）、WHO分型（P < 0.001）和PNI（P=0.016）是影响胸腺瘤术后患者总生存率的独立危险因素。分层分析结果显示，在PNI高值组（PNI > 45）中手术是否R0切除（P=0.001）和是否合并重症肌无力（P=0.039）是影响患者总生存率的独立危险因素；在PNI低值组（PNI≤45）中Masaoka分期（Ⅱ/Ⅰ: P=0.012; Ⅲ & Ⅳ/Ⅰ: P=0.048）、WHO分型（P=0.039）、手术是否R0切除（P < 0.001）和是否合并重症肌无力（P < 0.001）是影响患者总生存率的独立危险因素。合并有重症肌无力的患者容易出现PNI降低。
结论胸腺瘤患者术后总生存率与Masaoka分期、WHO分型、手术是否完整切除、是否合并重症肌无力和预后营养指数密切相关。对于存在重症肌无力的胸腺瘤患者PNI较低，总生存率较低，应常规监测PNI。
Abstract:ObjectiveTo evaluate the correlation of prognostic nutritional index(PNI) with overall survival of postoperative patients with thymoma.
MethodsThe clinical and pathological data of 173 postoperative patients with thymoma were analyzed retrospectively.
ResultsR0 resection (P < 0.001), myasthenia gravis (P < 0.001), Masaoka stage (Ⅱ/Ⅰ: P=0.012; Ⅲ & Ⅳ/Ⅰ: P=0.011), WHO type (P < 0.001) and PNI (P=0.016) were independent risk factors for OS of postoperative patients with thymoma. R0 resection (P=0.001) and myasthenia gravis (P=0.039) were independent risk factors for OS of higher PNI group (PNI > 45); and Masaoka stage (Ⅱ/Ⅰ: P=0.012; Ⅲ & Ⅳ/Ⅰ: P=0.048), WHO type (P=0.039), R0 resection (P < 0.001) and myasthenia gravis(P < 0.001) were independent risk factors for OS of lower PNI group (PNI≤45). Patients with myasthenia gravis are prone to have a decreased PNI.
ConclusionComplete resection, myasthenia gravis, Masaoka stage, WHO type and PNI are independent prognostic factors for postoperative patients with thymoma. Thymoma patients with myasthenia gravis have lower PNI and OS. PNI should be routinely monitored in thymoma patients with myasthenia gravis.
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Key words:
- Thymoma /
- Surgery /
- Prognostic nutritional index /
- Survival analysis
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Competing interests: The authors declare that they have no competing interests.作者贡献：王岩：研究方向的设计论证、数据的收集和统计分析及论文的写作曹玉：数据的统计分析殷金环：数据的收集刘俊峰：论文的写作及研究的设计
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图 1 预后营养指数对胸腺瘤术后患者总生存率的影响
Figure 1 Effect of PNI on overall survival of postoperative patients with thymoma
表 1 PNI高值组和低值组胸腺瘤患者的基线特征(n(%))
Table 1 General characteristics of postoperative patients with thymoma according to PNI (n(%))
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表 2 胸腺瘤术后患者总生存率影响因素的单因素分析
Table 2 Univariate analysis of influence factors for overall survival of postoperative patients with thymoma
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表 3 胸腺瘤术后患者总生存率影响因素的多因素分析
Table 3 Multivariate analysis of influence factors for overall survival of postoperative patients with thymoma
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表 4 胸腺瘤术后PNI≤45和PNI>45组患者总生存率影响因素的单因素分析
Table 4 Univariate analysis for influence factors for overall survival of postoperative patients with thymoma in PNI≤45 and PNI>45 groups
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表 5 胸腺瘤术后PNI≤45和PNI>45患者总生存率影响因素的多因素分析
Table 5 Multivariate analysis for influence factors for OS of postoperative patients with thymoma in PNI≤45 and PNI>45 groups
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