Predictive Value of the Prognostic Nutritional Index in Neoadjuvant Chemoradiotherapy for Rectal Cancer

预后营养指数对直肠癌新辅助放化疗的预测价值

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作者:Chika Mizutani #, Nobuhisa Matsuhashi #, Hiroyuki Tomita #, Takao Takahashi, Tomonari Suetsugu, Jesse Yu Tajima, Shigeru Kiyama, Itaru Yasufuku, Yoshihiro Tanaka, Naoki Okumura, Katsutoshi Murase, Manabu Futamura, Masaya Kawaguchi, Takuma Ishihara, Masayuki Matsuo, Tatsuhiko Miyazaki, Akira Hara, Ka

Aim

Prognostic nutritional index (PNI) and neutrophil-to-lymphocyte ratio (NLR) indicate nutritional status and host immunity. We used immunohistochemistry and apparent diffusion coefficient (ADC) values calculated using diffusion-weighted imaging (DWI) to investigate relationships of these factors with pathological and radiological characteristics in rectal cancer treated with neoadjuvant chemoradiotherapy (nCRT). Patients and

Conclusion

Patients with higher pretreatment PNI had greater changes in ADC values and stromal CD8 + T-cell counts, and those with greater PNI reduction from nCRT had a worse prognosis. Proper nutritional management during nCRT benefits patients and may lead to better prognosis in rectal cancer.

Methods

We evaluated expression levels of VEGFA, CD8, CD33, and ADC values in tumors pre/post nCRT; and analyzed the relationships between those factors and PNI, NLR in 32 patients.

Results

Pretreatment PNI negatively correlated with change in tumor stromal CD8 + T cells and positively correlated with ADC values. Pretreatment NLR and PNI change correlated with recurrence-free survival (RFS).

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