目的：评估预后营养指数(PNI)及改良格拉斯哥评分(mGPS)对结直肠癌(CRC)患者总生存期(OS)的预后价值。方法：选取2009年1月至2012年12月在我院接受根治性切除术的CRC患者，计算每位患者术前的PNI和mGPS评分并比较。采用受试者工作特征(ROC)曲线计算PNI的截断值，将患者分为高PNI组和低PNI组再进行生存分析，采用Kaplan-Meier分析、Log-rank检验以及Cox回归模型分析PNI和mGPS与OS的关系。结果：65岁以下患者较65岁及以上患者的PNI更高，mGPS为0~1分的患者较mGPS为2分患者的PNI更高，无脉管癌栓的患者较有脉管癌栓患者的mGPS更低，差异均有统计学意义(均P＜0.05)。以PNI为46.85分组，低PNI组64例，高PNI组78例。mGPS评分0分14例，1分93例，2分35例。Kaplan-Meier分析和Log-rank检验表明，高PNI组OS显著长于低PNI组(P=0.019)。mGPS为2分的患者OS显著短于mGPS为0~1分的患者(P=0.022)。单因素分析显示浸润深度为T₃~T₄、存在神经侵犯、有脉管癌栓、低PNI和mGPS为2分均是较短OS的危险因素(均P＜0.05)。多因素Cox回归分析显示TNM分期是CRC患者的独立预后因素。结论：PNI及mGPS对于评估CRC患者的预后具有一定的价值，可联合TNM分期作为生存的预后指标。

[1] SUNG H,FERLAY J,SIEGEL R L,et al.Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2021,71(3):209-249.
[2] LANDSKRON G,DE LAFUENTE M,THUWAJIT P,et al.Chronic inflammation and cytokines in the tumor microenvironment[J].J Immunol Res,2014:149185.
[3] PROCTOR M J,TALWAR D,BALMAR S M,et al.The relationship between the presence and site of cancer,an inflammation-based prognostic score and biochemical parameters.initial results of the Glasgow inflammation outcome study[J].Br J Cancer,2010,103(6):870-876.
[4] 杨昊，刘家铭，庄坤，等.术后血清 CEA 联合 CA19-9、YKL-40、CRP 和 IL-6 预测结直肠癌复发和生存的临床价值[J].现代医学，2022，50(9):1143-1150.
[5] GUO Y,WEI L,PATEL S H,et al.Serum Albumin:Early prognostic marker of benefit for immune checkpoint inhibitor monotherapy but not chemoimmunotherapy[J].Clin Lung Cancer,2022,23(4):345-355.
[6] PARK J H,WATT D G,ROXBURGH C S,et al.Colorectal cancer,systemic inflammation,and outcome:staging the tumor and staging the host[J].Ann Surg,2016,263(2):326-336.
[7] YAGYU T,YAMAMOTO M,TANIO A,et al.Risk factors for recurrence in elderly patients with stage II colorectal cancer:a multicenter retrospective study[J].BMC Cancer,2022,22(1):390.
[8] ROSSI S,BASSO M,STRIPPOLI A,et al.Are markers of systemic inflammation good prognostic indicators in colorectal cancer?[J].Clin Colorectal Cancer,2017,16(4):264-274.
[9] MATSUURA S,MORIKAWA K,ITO Y,et al.The geriatric nutritional risk index and prognostic nutritional index predict the overall survival of advanced non-small cell lung cancer patients[J].Nutr Cancer,2022,74(5):1606-1613.
[10] PARK S J,LEE J,KIM H,et al.Association between absolute lymphocyte count and overall mortality in patients with surgically resected gastric cancer[J].Korean J Intern Med,2021,36(3):679-688.
[11] TOKUNAGA R,SAKAMOTO Y,NAKAGAWA S,et al.prognostic nutritional index predicts severe complications,recurrence,and poor prognosis in patients with colorectal cancer undergoing primary tumor resection[J].Dis Colon Rectum,2015,58(11):1048-1057.
[12] BAHCECI A,KOTEK SEDEF A,ISIK D.The prognostic values of prognostic nutritional index in extensive-stage small-cell lung cancer[J].Anticancer Drugs,2022,33(1):e534-e540.
[13] TOMINAGA T,NONAKA T,HISANAGA M,et al.Prognostic value of the preoperative prognostic nutritional index in oldest-old patients with colorectal cancer[J].Surg Today,2020,50(5):449-459.
[14] TOKUNAGA R,SAKAMOTO Y,NAKAGAWA S,et al.Comparison of systemic inflammatory and nutritional scores in colorectal cancer patients who underwent potentially curative resection[J].Int J Clin Oncol,2017,22(4):740-748.
[15] DING R,CHEN Z,HE M,et al.Application value of combined detection of NLR,PNI,D-Dimer,CD3(+) T lymphocytes,and CEA in colorectal cancer screening[J].Dis Markers,2022:7913025.
[16] BAI X J,FENG L.Correlation between prognostic nutritional index,Glasgow prognostic score,systemic inflammatory response,and TNM staging in colorectal cancer patients[J].Nutr Cancer,2020,72(7):1170-1177.