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Objective:To investigate the prognostic value of Onodera's prognostic nutrition index (PNI) before treatment in patients with cervical and upper thoracic esophageal squamous cell carcinoma (CUTESCC) undergoing definitive chemoradiotherapy (dCRT) and its predictive value in the occurrence of ≥ grade 2 radiation esophagitis (RE).Methods:The data of 163 CUTESCC patients eligible for inclusion criteria admitted to the Fourth Hospital of Hebei Medical University from January 2012 to December 2017 were retrospectively analyzed. The receiver operating characteristic (ROC) curve was used to calculate the best cut-off value of PNI for predicting the prognosis of patients. The prognosis of patients was analyzed by univariate and Cox multivariate analyses. Logistics binary regression model was adopted to analyze the risk factors of ≥ grade 2 RE in univariate and multivariate analyses. The significant factors in logistic multivariate analysis were used to construct nomogram for predicting ≥ grade 2 RE.Results:The optimal cut-off value of PNI was 48.57 [area under the curve (AUC): 0.653, P<0.001]. The median overall survival (OS) and progression-free survival (PFS) were 26.1 and 19.4 months, respectively. The OS ( χ2=6.900, P=0.009) and PFS ( χ2=9.902, P=0.003) of patients in the PNI ≥ 48.57 group ( n=47) were significantly better than those in the PNI < 48.57 group ( n=116). Cox multivariate analysis showed that cTNM stage and PNI were the independent predictors of OS ( HR=1.513, 95% CI: 1.193-1.920, P=0.001; HR=1.807, 95% CI: 1.164-2.807, P=0.008) and PFS ( HR=1.595, 95% CI: 1.247-2.039, P<0.001; HR=2.260, 95% CI: 1.439-3.550, P<0.001). Short-term efficacy was another independent index affecting PFS ( HR=2.072, 95% CI: 1.072-4.003, P=0.030). Logistic multivariate analysis showed that the maximum transverse diameter of the lesion ( OR=3.026, 95% CI: 1.266-7.229, P=0.013), gross tumor volume (GTV) ( OR=3.456, 95% CI: 1.373-8.699, P=0.008), prescription dose ( OR=3.124, 95% CI: 1.346-7.246, P=0.009) and PNI ( OR=2.072, 95% CI: 1.072-4.003, P=0.030) were the independent factors affecting the occurrence of ≥ grade 2 RE. These four indicators were included in the nomogram model, and ROC curve analysis showed that the model could properly predict the occurrence of ≥ grade 2 RE (AUC=0.686, 95% CI: 0.585-0.787). The calibration curve indicated that the actually observed values were in good agreement with the predicted RE. Decision curve analysis (DCA) demonstrated satisfactory nomogram positive net returns in most threshold probabilities. Conclusions:PNI before treatment is an independent prognostic factor for patients with CUTESCC who received definitive chemoradiotherapy. The maximum transverse diameter of the lesion, GTV, prescription dose and PNI are the risk factors for ≥ grade 2 RE in this cohort. Establishing a prediction model including these factors has greater predictive value.
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OBJECTIVE@#To evaluate the implications of the prognostic nutrition index (PNI) in non-metastatic renal cell carcinoma (RCC) patients treated with surgery and to compare it with other hematological biomarkers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and systemic immune inflammation index (SII).@*METHODS@#A cohort of 328 non-metastatic RCC patients who received surgical treatment between 2010 and 2012 at Peking University First Hospital was analyzed retrospectively. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff values of the hematological biomarkers. The Youden index was maximum for PNI was value of 47.3. So we divided the patients into two groups (PNI≤ 47. 3 and >47. 3) for further analysis. Categorical variables [age, gender, body mass index (BMI), surgery type, histological subtype, necrosis, pathological T stage and tumor grade] were compared using the Chi-square test and Student' s t test. The association of the biomarkers with overall survival (OS) and disease-free survival (DFS) was analyzed using Kaplan-Meier methods with log-rank test, followed by multivariate Cox proportional hazards model.@*RESULTS@#According to the maximum Youden index of ROC curve, the best cut-off value of PNI is 47. 3. Low level of PNI was significantly associated with older age, lower BMI and higher tumor pathological T stage (P < 0.05). Kaplan-Meier univariate analysis showed that lower PNI was significantly correlated with poor OS and DFS (P < 0.05). In addition, older age, lower BMI, tumor necrosis, higher tumor pathological T stage and Fuhrman grade were significantly correlated with poor OS (P < 0.05). Cox multivariate analysis showed that among the four hematological indexes, only PNI was an independent factor significantly associated with OS, whether as a continuous variable (HR=0.9, 95%CI=0.828-0.978, P=0.013) or a classified variable (HR=2.397, 95%CI=1.061-5.418, P=0.036).@*CONCLUSION@#Low PNI was a significant predictor for advanced pathological T stage, decreased OS, or DFS in non-metastatic RCC patients treated with surgery. In addition, PNI was superior to the other hematological biomar-kers as a useful tool for predicting prognosis of RCC in our study. It should be externally validated in future research before the PNI can be used widely as a predictor of RCC patients undergoing nephrectomy.
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Humans , Prognosis , Nutrition Assessment , Carcinoma, Renal Cell/surgery , Retrospective Studies , Biomarkers , Kidney Neoplasms/pathologyABSTRACT
Onodera prognostic nutrition index (OPNI) is a simple and effective parameter. It is calculated by serum albumin level and peripheral blood lymphocyte count. Initially, OPNI is used to assess preoperative nutritional status and surgical risk. In recent years, researchers have found that OPNI is related to the prognosis of many tumors. Simple and accurate prognosis evaluation can help to select treatment methods for digestive system malignant tumors, determine the best pre-operative treatment time and operation time, and improve the survival rate of patients with diges-tive system malignant tumors. The authors review the related literatures at home and abroad, and summarize the research advances in the prognostic value of OPNI for malignant tumors of digestive systems.
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ObjectiveNecrotizing fasciitis (NF) has a high rate of deterioration and rapid progress, and the mortality rate is still high even after receiving treatment. The study was to explore evaluation value of serum procalcitonin (PCT), C-reactive protein (CRP) and plasma albumin (ALB) and prealbumin (PA) in the prognosis of patients with perianal necrotizing fasciitis (NF).MethodsAll data and detection data of serum PCT, CRP and plasma ALB, PA at admission from 41 perianal NF patients admitted to Hefei first people's Hospital Group from May 2009 to August 2019 were retrospectively collected. The death status was statistically analyzed. The patients in this group were divided into survival group and non-survival group, and the predictive value of various indicators on the prognosis of NF was evaluated. ResultsThe ratio of male to female was 9.25∶1. There were multiple complications, and diabetes mellitus was most common (41.46%). The patients with mixed infection and negative bacterial culture accounted for 12.20% and 17.07%, respectively. There were many kinds of bacteria detected out. Klebsiella pneumoniae (20.45%), Escherichia coli (15.91%) and streptococcus (15.91%) were common. All underwent one or more surgical treatments, with mortality of 17.07%. There was no significant difference between survival group and death group in gender, complications, microbiological test results, operation status within 6h or and nutrition support (P>0.05), while there were significant differences in time from onset to admission, proportion of patients in ICU, serum PCT and CRP, plasma ALB and PA and proportion of patients undergoing vacuum sealing drainage (VSD) (P<0.05). Logistic multivariate regression analysis showed that long duration from onset to admission, staying in ICU, high serum PCT and CRP, low plasma ALB and PA, and no conducting VSD were risk factors of poor prognosis (P<0.05). Serum PCT, CRP and plasma ALB, PA predict the prognosis receiver operating characteristic(ROC) curve, the area under the curve is 0.859, 0.811, 0.802, 0.747; the area under the curve of the four indicators combined prediction is 0.926.ConclusionThere are certain features in terms of gender, complications and microorganisms in perianal NF patients. Death risk is high. In addition, serum PCT and CRP, plasma ALB and PA are also related with prognosis, which can be applied as biochemical indexes for prognosis evaluation.
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Objective: To investigate the prognostic value of prognostic nutritional index (PNI) in patients with diffuse large B-cell lym-phoma (DLBCL). Methods: We retrospectively reviewed the medical records of 82 patients with DLBCL treated at Tianjin Union Medi-cal Center between June 2010 and June 2016. The optimal cutoff value of PNI was determined using a receiver operating characteristic (ROC) curve and the Youden index. The relationship of high and low PNI with the clinical characteristics of the patients, therapeutic ef-ficacy, and prognosis were analyzed. Results: Overall, mean PNI of the patients was 46.17±8.8. When the PNI was 44.15, the Youden in-dex was found to be maximal, with a sensitivity of 74.6% and specificity of 67.2%. There were 38 patients (46.3%) in the low PNI group (<44.15) and 44 patients (53.7%) in the high PNI group (≥44.15). Data analysis showed that PNI was correlated with Eastern Coopera-tive Oncology Group performance status (ECOG PS), Ann Arbor stage, international prognostic index (IPI) score, and lactic acid dehydro-genase (LDH) level (P<0.05). The total effective rate of the low PNI group was significantly lower than that of the high PNI group (65.8% vs. 86.4%; χ2=4.848; P=0.028). The 3-year overall survival (OS) rate of the entire group of patients was 69.1%. The 1-, 2-, and 3-year OS rates of the low PNI group (86.8%, 67.8%, and 56.9%, respectively) were significantly lower than that of the high PNI group (96.7%, 89.5%, and 80.2%, respectively; χ2=9.421, P=0.002). Univariate analysis showed that PNI<44.15, ECOG PS≥2, IPI>2, stageⅢ/Ⅳ, and lymphocyte count<1.0×109/L had a significant impact on predicting OS (P<0.05). Multivariate analysis showed that PNI<44.15 (P=0.006) and stageⅢ/Ⅳ(P=0.011) were independent factors for predicting OS. Conclusions: PNI might be used as a simple and feasible clinical prognostic indicator in patients with DLBCL.
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Objective To explore the clinical application value of prognostic nutritional index (PNI)for predicting overall survival(OS)in patients with advanced colorectal cancer.Methods Seventy-two patients with histologically confirmed colorectal cancer were enrolled in this study, and their clinical and laboratory data were reviewed.The PNI was calculated, and univariate and multivariate analysis was used to identify the potential prognostic factors for advanced colorectal cancer. Results PNI of the 72 colorectal cancer patients was 45.07 ± 5.98.PNI was significantly associated with age, weight loss and pleural effusion (P < 0.05). However, PNI showed no correlation with sex, clinical stage, smoking, bloody stool, abdominal mass, intestinal obstruction, histological type, radiotherapy and KPS scores (P>0.05).The median OS of the 72 patients was 12.9 months.The medium OS in the higher PNI group (PNI≥45.07)and lower PNI group(PNI≤45.07)was 15.7 months and 11.2 months, respectively.The 1-year survival rates were 78.4% and 60.5%, and 2-year survival rates were 53.1% and 20.8%, respectively(P<0.01).Univariate analysis showed that PNI, ages, and weight loss were related to the OS of the advanced colorectal cancer(P<0.05).Multivariate analysis identified PNI was an independent prognostic factor for OS of advanced colorectal cancer (P < 0.01). Conclusions PNI can be easily calculated, and may be used as a relatively new prognostic indicator for advanced colorectal cancer in clinical practice.
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ABSTRACT: The aim of this study was to evaluate popcorn genotypes for resistance to the fall armyworm, Spodoptera frugiperda. The experiment used a completely randomized design with 30 replicates. The popcorn genotypes Aelton, Arzm 05 083, Beija-Flor, Colombiana, Composto Chico, Composto Gaúcha, Márcia, Mateus, Ufvm Barão Viçosa, Vanin, and Viviane were evaluated,along with the common maize variety Zapalote Chico. Newly hatched fall armyworm larvae were individually assessed with regard to biological development and consumption of food. The data were subjected to multivariate analyses of variance and genetic divergence among genotypes was evaluated through the clustering methods of Tocher based on generalized Mahalanobis distances and canonical variable analyses. Seven popcorn genotypes, namely, Aelton, Arzm 05 083, Composto Chico, Composto Gaúcha, Márcia, Mateus, and Viviane,were shown to form a cluster (cluster I) that had antibiosis as the mechanism of resistance to the pest. Cluster I genotypes and the Zapalote Chico genotype could be used for stacking genes for antibiosis and non-preference resistance.
RESUMO: O objetivo do estudo foi avaliar genótipos de milho pipoca para resistência à lagarta-do-cartucho, Spodoptera frugiperda. O experimento foi conduzido em delineamento inteiramente casualizado com 30 repetições. Foram avaliados os genótipos de milho pipoca Aelton, Arzm 05 083, Beija-Flor, Colombiana, Composto Chico, Composto Gaúcha, Márcia, Mateus, Ufvm Barão Viçosa, Vanin, Viviane e Zapalote Chico. Larvas recém-eclodidas foram individualizadas para avaliação do desenvolvimento biológico e consumo alimentar. Os dados foram submetidos à análise multivariada de variância e a divergência genética entre genótipos foi avaliada através dos métodos de agrupamento de Tocher, com base na distância generalizada de Mahalanobis e análise de variáveis canônicas. Sete genótipos,Aelton, Arzm 05 083, Composto Chico, CompostoGaúcha, Márcia, Mateus e Viviane formaram um cluster (cluster I) que apresentaram antibiose com o mecanismo de resistência à praga. Os genótipos do cluster I e Zapalote Chico podem ser usados para empilhar genes para resistência por antibiose e não-preferência.
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Objective To investigate the effect of L-carnitine combined with psychological intervention on nutritional status and inflammatory status in maintenance hemodialysis patients. Methods 75 cases of maintenance hemodialysis patients treated in our hospital from September 2016 to December 2016 were randomly divided into control group(n=37) and study group(n=38)by single and double number method (hospital visit order). The control group in the hemodialysis treatment combined with Levocarnitine; the study group in the use of L-carnitine combined with psychological intervention. Results There were no significant differences in ALB, Hb, BMI, IL-6 and CRP between the two groups before treatment. After the corresponding treatment, the improvement of ALB, Hb, BMI, IL-6, CRP and other inflammatory indexes and nutritional indexes in the study group were better than those in the control group(P<0.05). Conclusion The application of L-carnitine in maintenance hemodialysis patients combined with psychological intervention can significantly improve the body's Micro inflammatory status and nutrition indicators, has positive significance to protect the patients' quality of life and physical and mental health.
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Objective To explore the effect of nutritional risk and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ) on the prognosis of critically ill patients. Methods From January 2014 to November 2015, 138 critically ill patients were screened using Nutritional Risk Screening 2002 (NRS-2002) in intensive care unit (ICU) of our hospital. APACHEⅡand nutritional status of the patients were measured at the same time. Patients were divided into the survival group and death group according to the prognosis,the NRS-2002, nutritional status and APACHEⅡscores were compared between the two groups.The effect of NRS-2002 and APACHEⅡon the prognosis of critically ill patients was analyzed. Results Of 138 critically ill patients, 131 cases were found nutritional risk and 82 patients survived (62.60%) ,7 cases were found without nutritional risk and 5 patients survived,There were no significant differences in survival rate of both groups(P=0.714). The APACHEⅡscores in the nutritional risk group were (22.14 ± 6.86) points, which were obviously higher than those of non-nutritional risk group(5.80 ± 1.90)points. There were significant differences(t′=17.47,P0.05).Logistic regression analysis showed APACHEⅡ, nutritional risks, RBC,HGB,ALB and CRP were all the risk factors for the prognosis of critically ill patients(P<0.01), while APACHEⅡ, RBC, nutritional risks and ALB were the leading influencing factors. Conclusions There exists higher nutritional risks among the critically ill patients. APACHEⅡ, RBC, nutritional risks and ALB should be given more attention when they are admitted in the ICU. Patients′nutritional status should be comprehensively evaluated and the prognosis of the patients should be predicted.
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Objective:To retrospectively evaluate the prognostic risk factors of patients with gallbladder carcinoma and the effect of normal prognostic nutrition index (PNI) on the survival. Methods:We retrospectively analyzed 63 patients with gallbladder carcino-ma treated in our hospital between January 2008 and December 2012. The independent prognostic factors of the patients were calculat-ed by the Cox proportional hazards model. The benefit of normal PNI status on the prognosis was further explored in the patients using survival analysis. Results:Lymph node metastasis, PNI≤50, squamous carcinoma, liver invasion and choledoch invasion were the risk factors of overall survival (OS) in the univariate analysis, while only lymph node metastasis (HR=4.495, 95%CI 2.380~8.488, P65y) (younger group:P=0.011;elder group:P=0.078). Conclusion:The gallbladder carcinoma patients with normal PNI status (>50) have better OS compared to the patients with PNI≤50, with statistical differences between the two. And it is more significant in the patients of the younger group (≤65y), comparing with the elder group. PNI could be taken as a potential prognostic evaluation factor for the gallbladder carcinoma patients and can provide a more comprehensive evaluation of patients' conditions to clinician.
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PURPOSE: This study has been conducted to analyze whether the biochemical nutrition indexes might be useful and effective for evaluating the nutrition states of children. METHODS: We evaluated 269 children, aged 3-9 years old, who had visited Gangneung Asan Hospital for elective surgery from January 2006 to December 2007, and examined their anthropometric and preoperative laboratory data with retrospective analysis. The children were classified into underweight, normal weight, overweight, and obese groups according to body mass index (BMI). The biochemical nutrition indexes (total lymphocyte count (TLC), hemoglobin, hematocrit, serum albumin, cholesterol, et al) of each group were then analyzed statistically. RESULTS: None of the groups showed statistically significant differences in TLC. Serum albumin decreased significantly in the underweight group. Red blood cell (RBC) count, hemoglobin, hematocrit, and serum total cholesterol in the obese group were higher than in the normal weight group. None of the groups showed statistically significant increase in mean corpuscular volume or mean corpuscular hemoglobin, and it seems that the increase of hemoglobin and RBC count in the overweight and obese groups is due to the enhancement of erythropoiesis rather than iron metabolism. However, in females, almost all nutrition indexes except albumin were statistically significantly poor. CONCLUSION: Serum albumin, total cholesterol, RBC count, hemoglobin, and hematocrit were useful as nutrition indexes. However, except for albumin, these indexes were significantly poor for females. More control studies are needed to confirm the effectiveness of biochemical indexes for evaluating the nutritional state of children.