PNI, As a Nutritional and Inflammatory Index, Was Able to Predict Prognosis of Patients With Pancreatic Neuroendocrine Carcinoma

Abstract

\n Background: Recent studies have indicated that there is a strong link between the prognosis of cancer and the nutritional status. The purpose of this study is to investigate whether an indicator of nutritional status- the prognostic nutritional index (PNI), could affect overall survival in patients with pancreatic neuroendocrine carcinoma (p-NEC). Methods: A total of 147 patients with p-NEC, who had successfully undergone biopsy by surgical operation in Shandong Provincial Hospital Affiliated to Shandong University from October 2010 to February 2019, were investigated. The serum albumin concentration and absolute lymphocyte count were used to calculate the PNI: serum albumin concentration (g/L) +5×total lymphocyte count (×109/L).Results: Mean pretreatment PNI was 47.6. Weight loss (P = 0.003), lymphatic metastasis (P=0.006) and tumor ENETS (European Neuroendocrine Tumor Society) stage (P = 0.024), were significantly associated with PNI. Univariate analysis showed that the following factors caused decreased overall survival (OS): age (≧60years, p=0.006, vs. <60years), abdominal pain (p=0.038, vs absence of abdominal pain), weight loss (p=0.025, vs. absence of weight loss), lymphatic metastasis (p=0.0000 vs. absence of lymphatic metastasis) and tumor ENETS stage (I–II，p=0.0000, vs. III–IV). Following the multivariate analysis, PNI remained an independent prognostic factor in p-NEC. Patients with lower PNIs (PNI < 47.6) had higher risk of death than those with higher PNIs (PNI ≧ 47.6; hazard ratio: 4.508; 95 % confidence interval: 1.903–10.678; P = 0.001). Conclusions: Our present study indicated that pretreatment PNI may be a novel independent prognostic factor in patients with p-NEC.