背景:营养风险指数(NRI)是各种癌症总体生存的独立预后因素,但其在乳腺癌中的预后价值尚不清楚。本研究旨在探讨NRI与乳腺癌总生存期(OS)之间的关系,并建立预测列线图。
方法:我们回顾性地纳入了在2011年1月至2012年11月期间接受乳房切除术或乳房肿瘤切除术的1347例乳腺癌患者。使用临界值110.59,将患者分为高NRI组和低NRI组。比较两组OS。使用与生存独立相关的临床病理因素来构建预测列线图。
结果:在1347名患者中,534例患者被分类为高NRI,813例被分类为低NRI。低NRI患者的OS显著缩短。3年和5年OS率分别为87.3%和73.4%,分别,在高NRI组中,它们分别为83.0%和67.2%,分别,在低NRI组中。Cox回归分析发现,组织病理类型,肿瘤大小,淋巴结状态,孕激素受体(PR)状态,Ki-67和NRI与OS独立相关。
结论:NRI是乳腺癌患者OS的独立预后因素。所提出的列线图模型可能是用于个性化生存预测的有用工具。
BACKGROUND: The nutritional risk index (NRI) is an independent prognostic factor for overall survival in various cancers, but its prognostic value in breast cancer remains unclear. This study aimed to explore the relationship between the NRI and overall survival (OS) in breast cancer and to develop a predictive nomogram.
METHODS: We retrospectively enrolled 1347 breast cancer patients who underwent mastectomy or lumpectomy between January 2011 and November 2012. Using a cutoff value of 110.59, patients were divided into a high-NRI group and a low-NRI group. OS was compared between the two groups. Clinicopathological factors independently associated with survival were used to construct a predictive nomogram.
RESULTS: Of the 1347 patients, 534 patients were classified as high NRI and 813 as low NRI. OS was significantly shorter in low-NRI patients. The 3- and 5-year OS rates were 87.3% and 73.4%, respectively, in the high-NRI group whereas they were 83.0% and 67.2%, respectively, in the low-NRI group. Cox regression analysis found that histopathological type, tumor size, lymph node status, progesterone receptor (PR) status, Ki-67, and NRI were independently associated with OS.
CONCLUSIONS: NRI is an independent prognostic factor of OS in breast cancer patients. The proposed nomogram model may be a useful tool for individualized survival prediction.