Jincong Min, Ting Liu, Mimi Tang, Xuan Li, Xiang Feng, Heli Liu, Jie Ge
{"title":"晚期胃癌根治术后全身炎症和营养指数的性别差异。","authors":"Jincong Min, Ting Liu, Mimi Tang, Xuan Li, Xiang Feng, Heli Liu, Jie Ge","doi":"10.11817/j.issn.1672-7347.2024.240120","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Albumin-globulin ratio (AGR), prognostic nutritional index (PNI), and platelet-to-lymphocyte ratio (PLR) have been validated as prognostic factors for gastric cancer (GC). However, significant gender differences exist in albumin levels and inflammatory cell counts, and further research is required to understand how these differences influence GC prognosis. This study aims to investigate the prognostic impact of nutritional and inflammatory indicators on GC patients undergoing radical surgery, as well as the influence of gender on these indicators' prognostic value.</p><p><strong>Methods: </strong>The study included 596 patients with advanced GC hospitalized in the Department of Gastrointestinal Surgery, General Surgery, Xiangya Hospital of Central South University from January 2012 to December 2016. Receiver operating characteristic (ROC) analysis was performed to determine cutoff values for nutritional and inflammatory factors. Univariate analysis was used to identify factors significantly affecting survival in GC patients, while multivariate and Kaplan-Meier analyses determined independent prognostic factors for GC.</p><p><strong>Results: </strong>Multivariate analysis revealed that postsurgical tumor node metastasis (pTNM) stage [stage II: hazard ratio (<i>HR</i>)=3.284, <i>P</i>=0.012; stage III: <i>HR</i>: 8.062, <i>P</i><0.001], low preoperative AGR (<i>HR</i>=1.499, <i>P</i>=0.012), and postoperative PNI (<i>HR</i>=1.503, <i>P</i>=0.008) were risk factors for overall survival in male patients after radical GC surgery. For female patients, pN2-3 (<i>HR</i>=3.185, <i>P</i><0.001), total gastrectomy (<i>HR</i>=2.286, <i>P</i>=0.004), low preoperative PLR (<i>HR</i>=1.702, <i>P</i>=0.027), and postoperative PNI (<i>HR</i>=1.943, <i>P</i>=0.011) were identified as risk factors for overall survival.</p><p><strong>Conclusions: </strong>Postoperative PNI is an independent risk factor for all advanced GC patients. Preoperative PLR is an independent prognostic factor only for female patients, while preoperative AGR is an independent prognostic factor only for male patients. Further research is warranted to investigate the gender-specific differences in GC prognosis.</p>","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"49 8","pages":"1232-1244"},"PeriodicalIF":0.0000,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628231/pdf/","citationCount":"0","resultStr":"{\"title\":\"Gender differences in systemic inflammatory and nutritional index following radical surgery for advanced gastric cancer.\",\"authors\":\"Jincong Min, Ting Liu, Mimi Tang, Xuan Li, Xiang Feng, Heli Liu, Jie Ge\",\"doi\":\"10.11817/j.issn.1672-7347.2024.240120\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Albumin-globulin ratio (AGR), prognostic nutritional index (PNI), and platelet-to-lymphocyte ratio (PLR) have been validated as prognostic factors for gastric cancer (GC). However, significant gender differences exist in albumin levels and inflammatory cell counts, and further research is required to understand how these differences influence GC prognosis. This study aims to investigate the prognostic impact of nutritional and inflammatory indicators on GC patients undergoing radical surgery, as well as the influence of gender on these indicators' prognostic value.</p><p><strong>Methods: </strong>The study included 596 patients with advanced GC hospitalized in the Department of Gastrointestinal Surgery, General Surgery, Xiangya Hospital of Central South University from January 2012 to December 2016. Receiver operating characteristic (ROC) analysis was performed to determine cutoff values for nutritional and inflammatory factors. Univariate analysis was used to identify factors significantly affecting survival in GC patients, while multivariate and Kaplan-Meier analyses determined independent prognostic factors for GC.</p><p><strong>Results: </strong>Multivariate analysis revealed that postsurgical tumor node metastasis (pTNM) stage [stage II: hazard ratio (<i>HR</i>)=3.284, <i>P</i>=0.012; stage III: <i>HR</i>: 8.062, <i>P</i><0.001], low preoperative AGR (<i>HR</i>=1.499, <i>P</i>=0.012), and postoperative PNI (<i>HR</i>=1.503, <i>P</i>=0.008) were risk factors for overall survival in male patients after radical GC surgery. For female patients, pN2-3 (<i>HR</i>=3.185, <i>P</i><0.001), total gastrectomy (<i>HR</i>=2.286, <i>P</i>=0.004), low preoperative PLR (<i>HR</i>=1.702, <i>P</i>=0.027), and postoperative PNI (<i>HR</i>=1.943, <i>P</i>=0.011) were identified as risk factors for overall survival.</p><p><strong>Conclusions: </strong>Postoperative PNI is an independent risk factor for all advanced GC patients. Preoperative PLR is an independent prognostic factor only for female patients, while preoperative AGR is an independent prognostic factor only for male patients. Further research is warranted to investigate the gender-specific differences in GC prognosis.</p>\",\"PeriodicalId\":39801,\"journal\":{\"name\":\"中南大学学报(医学版)\",\"volume\":\"49 8\",\"pages\":\"1232-1244\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628231/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中南大学学报(医学版)\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.11817/j.issn.1672-7347.2024.240120\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中南大学学报(医学版)","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.11817/j.issn.1672-7347.2024.240120","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Gender differences in systemic inflammatory and nutritional index following radical surgery for advanced gastric cancer.
Objectives: Albumin-globulin ratio (AGR), prognostic nutritional index (PNI), and platelet-to-lymphocyte ratio (PLR) have been validated as prognostic factors for gastric cancer (GC). However, significant gender differences exist in albumin levels and inflammatory cell counts, and further research is required to understand how these differences influence GC prognosis. This study aims to investigate the prognostic impact of nutritional and inflammatory indicators on GC patients undergoing radical surgery, as well as the influence of gender on these indicators' prognostic value.
Methods: The study included 596 patients with advanced GC hospitalized in the Department of Gastrointestinal Surgery, General Surgery, Xiangya Hospital of Central South University from January 2012 to December 2016. Receiver operating characteristic (ROC) analysis was performed to determine cutoff values for nutritional and inflammatory factors. Univariate analysis was used to identify factors significantly affecting survival in GC patients, while multivariate and Kaplan-Meier analyses determined independent prognostic factors for GC.
Results: Multivariate analysis revealed that postsurgical tumor node metastasis (pTNM) stage [stage II: hazard ratio (HR)=3.284, P=0.012; stage III: HR: 8.062, P<0.001], low preoperative AGR (HR=1.499, P=0.012), and postoperative PNI (HR=1.503, P=0.008) were risk factors for overall survival in male patients after radical GC surgery. For female patients, pN2-3 (HR=3.185, P<0.001), total gastrectomy (HR=2.286, P=0.004), low preoperative PLR (HR=1.702, P=0.027), and postoperative PNI (HR=1.943, P=0.011) were identified as risk factors for overall survival.
Conclusions: Postoperative PNI is an independent risk factor for all advanced GC patients. Preoperative PLR is an independent prognostic factor only for female patients, while preoperative AGR is an independent prognostic factor only for male patients. Further research is warranted to investigate the gender-specific differences in GC prognosis.
期刊介绍：
Journal of Central South University (Medical Sciences), founded in 1958, is a comprehensive academic journal of medicine and health sponsored by the Ministry of Education and Central South University. The journal has been included in many important databases and authoritative abstract journals at home and abroad, such as the American Medline, Pubmed and its Index Medicus (IM), the Netherlands Medical Abstracts (EM), the American Chemical Abstracts (CA), the WHO Western Pacific Region Medical Index (WPRIM), and the Chinese Science Citation Database (Core Database) (CSCD); it is a statistical source journal of Chinese scientific and technological papers, a Chinese core journal, and a "double-effect" journal of the Chinese Journal Matrix; it is the "2nd, 3rd, and 4th China University Excellent Science and Technology Journal", "2008 China Excellent Science and Technology Journal", "RCCSE China Authoritative Academic Journal (A+)" and Hunan Province's "Top Ten Science and Technology Journals". The purpose of the journal is to reflect the new achievements, new technologies, and new experiences in medical research, medical treatment, and teaching, report new medical trends at home and abroad, promote academic exchanges, improve academic standards, and promote scientific and technological progress.
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