Comparison of the prognostic value of 15 nutritional/inflammatory indicators in postoperative cancer patients
10.3969/j.issn.1006-7795.2025.03.003
- VernacularTitle:15种营养/炎症指标对手术后肿瘤患者的预后预测能力比较
- Author:
Xiaoqian LIU
1
;
Kai SUN
;
Xiaolin WANG
;
Qianqian ZHAO
;
Xiaoxiao WU
;
Fangqi SHEN
;
Xi CHEN
;
Chenxu TIAN
;
Di WU
;
Chunhua SONG
;
HongXia XU
;
Minghua CONG
;
Hanping SHI
;
Pingping JIA
Author Information
1. 首都医科大学附属北京世纪坛医院临床营养科,北京 100038;国家市场监管重点实验室(肿瘤特医食品),北京 100038
- Publication Type:Journal Article
- Keywords:
inflammation indicators;
nutritional indicators;
cancer;
postoperative outcomes;
prognosis prediction
- From:
Journal of Capital Medical University
2025;46(3):410-419
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore and identify the nutritional/inflammatory indicator with the highest predictive potential for overall survival(OS)in postoperative tumor patients so as to provide guidance for postoperative rehabilitation of tumor patients.Methods Data from 3 191 surgical patients were collected,including 15 nutritional/inflammatory indicators.The maximum selection rank statistic method was used to calculate the optimal cut-off values for continuous indicators.The Kaplan-Meier method was used to assess OS,and Cox proportional hazards models were used to analyze the association between the aforementioned 15 indicators and survival.The predictive value of these 15 indicators was evaluated with receiver operating characteristic(ROC)curves and C-index.Results Multivariate analysis showed that all 15 indicators were significantly associated with poorer OS in surgical patients(P＜0.05 for all).Time-dependent area under the curve(AUC)and C-index analysis indicated that 3 indicators with the highest predictive potential in OS in postoperative tumor patients were the nutritional risk index(NRI)(C-index:0.597),C-reactive protein-to-albumin ratio(CAR)(C-index:0.587),and C-reactive protein-to-lymphocyte ratio(CLR)(C-index:0.587).The optimal cut-off value for NRI was determined to be 104.31(i.e.,NRI＜104.31 suggests malnutrition)with the maximum selection rank statistic method,the optimal cut-off value for CAR to be 0.05(i.e.,CAR≥0.05 suggests a strong inflammatory response,often accompanied by malnutrition),and the optimal cut-off value for CLR to be 1.18(i.e.,CLR≥1.18 suggests a strong inflammatory response).Subgroup analysis indicated that NRI,CAR,and CLR had good correlation with tumor staging,and there were significant differences between tumor node metastasis(TNM)Ⅲ/Ⅳ stage patients and TNM Ⅰ/Ⅱ stage patients when there was a strong inflammatory response or malnutrition.Conclusion In postoperative tumor patients,NRI,CLR,and CAR have high prognostic value.Combining these with the patient's clinical stage,it enables more precise guidance for clinical diagnosis and treatment strategies.
