AUTHOR=Wei Jiangpeng , Lu Ju , Jia Hanxiang , Yang Xisheng , Guo Xin , Liu Jinqiang , Li Xiaohua 

TITLE=Value of a preoperative prognostic nutritional index for the prognostic evaluation of gastric neuroendocrine carcinoma patients

JOURNAL=Frontiers in Nutrition

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1043550

DOI=10.3389/fnut.2023.1043550

ISSN=2296-861X

ABSTRACT=<sec id="sec1"><title>Objective</title><p>To study the value of Onodera’s prognostic nutrition index (PNI) in patients with gastric neuroendocrine cancer (G-NEC).</p></sec><sec id="sec2"><title>Methods</title><p>The clinical data on 148 cases of G-NEC presented between March 2010 and April 2022 were retrospectively analyzed. The relationship between the clinical characteristics of the patients and PNI was analyzed. Optimal PNI cutoff values for G-NEC prognosis prediction were calculated using the X-tile software. The survival curves were created using the Kaplan–Meier method. A Cox proportional hazards model was also established to identify independent prognostic factors that impact the prognosis of patients with G-NEC.</p></sec><sec id="sec3"><title>Results</title><p>The median overall survival (OS) rate was 30 months (range 6–127 months), and the OS rates at 1, 3 and 5 years were 89.2, 71.6 and 68.2%, respectively. The mean PNI of the 148 patients before the operation was 49.5 ± 8.0. The mean PNI of patients with anemia (<italic>p</italic> &lt; 0.001) and abnormal carcinoembryonic antigen (<italic>p</italic> = 0.039) was significantly lower than that of patients without such comorbidities. The mean PNI of patients with Stage III tumors (<italic>p</italic> &lt; 0.001) and postoperative complications was significantly lower (<italic>p</italic> = 0.005). PNI optimal cutoff values were 50 (<italic>p</italic> &lt; 0.001). Based on the cut-off value of the PNI, these patients were divided into a PNI-high group (PNI ≥ 50.0, <italic>n</italic> = 77) and a PNI-low group (PNI &lt; 50.0, <italic>n</italic> = 71). The PNI-high group had a significantly better 5-years OS rate compared with the PNI-low group (76.6% vs. 59.2%, <italic>χ</italic><sup>2</sup> = 14.7, <italic>p</italic> &lt; 0. 001). Multivariate analysis demonstrated that PNI and pathological stage were independent prognostic factors for patients with G-NEC. In the subgroup analysis, OS rates were significantly lower in the PNI-low group than in the PNI-high group among patients with stage I and stage III of the disease.</p></sec><sec id="sec4"><title>Conclusion</title><p>The PNI is a simple and useful marker for predicting long-term outcomes in G-NEC patients regardless of tumor stage. Based on our results, we suggest that PNI should be included in routine assessments of patients with G-NEC.</p></sec>