那不勒斯预后评分和预后营养指数对子宫内膜癌患者术后复发的预测价值

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中图分类号：R737.33 文献标志码：A DOI：10.11958/20242339

Abstract： ObjectiveTo investigate the impact Naples prognostic score （NPS） prognostic nutritional index （PNI）on postoperative recurrnce survival in patients with endometrialcancer （EC）.MethodsA total 258EC patients wereselectedforsurgical treatment.Clinicaldatasuchasthepatients‘ageatadmission，pathological grade，depth myometrial invasion，lymphovascularspace invasion（LVSI），lymph odemetastasis clinical stagethe Inteational Society Gynecological Oncology （FIGO）werecollcted.Oneweek before theoperation，thelaboratory indicators were detected in patients， NPSPNI were calculated.The patients were followed updivided into the recurrence group 0 n =72） the non-recurrence group （ n =186）according to whether there was recurrence after the operation. The recurrence curves were plottdusing Kaplan-Meier method，theLog-rank test wasusedtocompare thediferences inrecurrence curves betweenpatients withdiferentNPSPNI.TheCox proportional hazardsregressionmodel wasused toanalyze the influencing factors postoperative recurence inpatients with EC.The receiver operating characteristic （ROC） curve was used toevaluate the predictiveefcacyPNINPSscoresforpostoperativerecurrence inpatientswithEC.Results The proportion patients withhigh-risk NPS scores was significantly higher in therecurrencegroupthan thatinthe nonrecurrence group （41.7% vs. 19.4% P<0.05 ）. The PNI was significantly lower in the recurrence group than that in the nonrecurrence group 42.1±7.6 vs. 47.2±8.9， P<0.01 ）.Multivariate Cox regression analysis showed that advanced age， elevated serum carbohydrateantigen125（CA125），pathological grades G2 G3，myometrial invasion depth > 1/2， positive LVSI，

FIGO stage Il-IV medium-high risk patients with NPS score were independent risk factors forrecurrene.Postoperative radiotherapy chemotherapy elevated PNI were independent protective factors for recurence inpatients.ROC curve analysis showedthatthecombined predictivevalue NPS score PNI forpostoperativerecurence inpatients with EC wassuperiorto that individual predictions.ConclusionBothNPSPNIcanbeusedaspotentialindicators topredict the prognosis patients with endometrial cancer.

Key words： endometrial neoplasms; progosis;nutritionassessment; naplesprognostic score;surivalanalysis; ROCcurve

子宫内膜癌（Endometrialcancer，EC）是女性常见的妇科恶性肿瘤之一，尽管手术治疗、放化疗以及激素治疗等手段显著改善了患者的预后，但仍有一部分患者出现复发，预后较差[1]。（剩余10004字）