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

Background/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 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). 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.

Impact of Dietary Diversification on the Prognostic Inflammatory and Nutritional Index in School-Age Children in the Nawa Region (Côte d’Ivoire)

The objective of this work was to study the impact of food diversification based on sweet potato, soybean, and cowpea on the prognostic inflammatory and nutritional index (PINI) in school-aged children in the Nawa region. This study took place from October 2017 to May 2018 among 240 pupils aged 6 to 12, divided into four groups of 60. Four types of meals were proposed: rice with tomato soup and fish (group 1), sweet potato porridge enriched with green soybeans (group 2), sweet potato porridge enriched with white cowpea (group 3), or sweet potato porridge accompanied by white cowpea with green soybeans (group 4). There were three blood samples: before eating meals (phase 0), the end of the first trimester (phase 1), and the end of the second trimester (phase 2). Blood assay for C-reactive protein (CRP), orosomucoid, albumin, and prealbumin was performed using COBAS c311 analyzer. PINI was calculated. Groups 3 and 4 showed a slight increase in albumin values (42.24 ± 0.95 g/L and 41.51 ± 1.71 g/L, respectively) compared to group 1. CRP decreased from phase 1 for group 1 (2.06 ± 0.26 mg/L) and group 4 (2.38 ± 0.36 mg/L). Orosomucoid increased insignificantly (p > 0.05) in group 3 (0.74 ± 0.04 g/L) and group 4 (0.71 ± 0.04 g/L). PINI was reduced by 0.37 (group 1), 0.36 (group 2), 0.46 (group 3) and 0.44 (group 4). Food diversification based on sweet potato and white cowpea has a positive impact on PINI in more than 80% of pupils.

Intervention Value of Path-Type Health Education on Cognition and Renal Function of Patients with Diabetic Nephropathy

Objective. Analyze and examine the effectiveness of path-based health education for patients with diabetic nephropathy and renal function. Methods. The 162 diabetic nephropathy patients admitted to our hospital from January 2018 to January 2021 were selected, and participants were randomly assigned to groups: study group ( n = 79 ) and control group ( n = 83 ). The control group received routine nursing care, whereas the study group received path-type health education. GQOLI-74, MUIS-A scores, biochemical indicators, dietary indicators, cognition, blood glucose levels, and renal function were compared between the two groups. Results. The GQOLI-74 score of the two groups was substantially higher, while the MUIS-A score was significantly lower, although the study group changed more significantly ( P < 0.05 ) than the control group. The biochemical markers in both groups decreased significantly, but the study group changed more dramatically ( P 0.05 ) than the control group; the nutritional index values of both groups increased significantly, but the study group’s nutritional index values increased significantly ( P 0.05 ) when compared to those of the control group; the control group’s awareness of drug treatment, basic knowledge, exercise, and diet was 79.4 percent, 78.9 percent, 73.4 percent, and 91.0 percent, respectively, and the study group’s awareness of drug treatment, basic knowledge, exercise, and diet was 90.3%, 96.4%, 92.8%, and 94.0%. The study group exhibited greater awareness ( P 0.05 ) than the control group. The blood glucose indices of both groups were dramatically lowered; however, the study group’s blood glucose level declined more significantly ( P 0.05 ) than the control group. The renal function indices of both groups were considerably lower, but the study group’s renal function indexes were significantly lower ( P 0.05 ) than those of the control group. Conclusion. Pathway health education is a new nursing method that can adjust nutritional indicators, improve blood sugar and kidney function, and significantly increase patients’ awareness of the disease, which can further improve patient compliance with treatment. This nursing method has high application feasibility and high clinical value.

Prognostic Value of the Systemic Immune-Inflammation Index and Prognostic Nutritional Index in Patients With Medulloblastoma Undergoing Surgical Resection

Background: The progression and metastasis of cancers are associated with systematic immune inflammation and nutritional dysfunction. The systemic immune-inflammation index and prognostic nutritional index (PNI) have shown a prognostic impact in several malignancies. Therefore, our study aimed to evaluate immune inflammation and nutritional index prognostic significance in patients with medulloblastoma (MB).Methods: We retrospectively analyzed 111 patients with MB between 2001 and 2021 at our institution. The optimal cutoff values for systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte counts ration (MLR), and PNI were evaluated with receiver operating characteristic (ROC) curve analysis. Clinical characteristics and SII, NLR, MLR, and PNI were tested with the Pearson's chi-squared test. The Kaplan–Meier survival curves and the Cox proportional hazards model were used to evaluate the effects of immune inflammation and nutritional index on overall survival (OS).Results: Receiver operating characteristic curve analysis determined the optimal SII, NLR, MLR, and PNI cutoff values of 2,278, 14.83, 0.219, and 56.5 that significantly interacts with OS and divided the patients into two groups. Comparative survival analysis exhibited that the high-SII cohort had significantly shorter OS (p = 0.0048) than the low-SII cohort. For the univariate analysis, the results revealed that preoperative hydrocephalus (p = 0.01), SII (p = 0.006), albumin–bilirubin score (ALBI) (p = 0.04), and coSII–PNI were predictors of OS. In the multivariate analysis, preoperative hydrocephalus (p &lt; 0.001), ALBI (p = 0.010), SII (p &lt; 0.001), and coSII–PNI as independent prognostic factors were significantly correlated with OS.Conclusion: The preoperative SII, ALBI, and coSII–PNI serve as robust prognostic biomarkers for patients with MB undergoing surgical resection.

Prediction Efficacy of Prognostic Nutritional Index and Albumin–Bilirubin Grade in Patients With Intrahepatic Cholangiocarcinoma After Radical Resection: A Multi-Institutional Analysis of 535 Patients

BackgroundThe preoperative nutritional status and the immunological status have been reported to be independent prognostic factors of patients with intrahepatic cholangiocarcinoma (ICC). This study aimed to investigate whether prognostic nutritional index (PNI) + albumin–bilirubin (ALBI) could be a better predictor than PNI and ALBI alone in patients with ICC after radical resection.MethodsThe prognostic prediction evaluation of the PNI, ALBI, and the PNI+ALBI grade was performed in 373 patients with ICC who underwent radical resection between 2010 and 2018 at six Chinese tertiary hospitals, and external validation was conducted in 162 patients at four other Chinese tertiary hospitals. Overall survival (OS) and relapse-free survival (RFS) were estimated using the Kaplan–Meier method. Multivariate analysis was conducted to identify independent prognostic factors. A time-dependent receiver operating characteristic (ROC) curve and a nomogram prediction model were further constructed to assess the predictive ability of PNI, ALBI, and the PNI+ALBI grade. The C-index and a calibration plot were used to assess the performance of the nomogram models.ResultsUnivariate analysis showed that PNI, ALBI, and the PNI+ALBI grade were prognostic factors for the OS and RFS of patients with ICC after radical resection in the training and testing sets (p &lt; 0.001). Multivariate analysis showed that the PNI+ALBI grade was an independent risk factor for OS and RFS in the training and testing sets (p &lt; 0.001). Analysis of the relationship between the PNI+ALBI grade and clinicopathological characteristics showed that the PNI+ALBI grade correlated with obstructive jaundice, alpha-fetoprotein (AFP), cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA125), PNI, ALBI, Child–Pugh grade, type of resection, tumor size, major vascular invasion, microvascular invasion, T stage, and N stage (p &lt; 0.05). The time-dependent ROC curves showed that the PNI+ALBI grade had better prognostic predictive ability than the PNI, ALBI, and the Child–Pugh grade in the training and testing sets.ConclusionPreoperative PNI+ALBI grade is an effective and practical predictor for the OS and RFS of patients with ICC after radical resection.