Cholesterol-modified prognostic nutritional index (CPNI) as an effective tool for assessing the nutrition status and predicting survival in patients with breast cancer

作者：Jinyu Shi, Tong Liu, Yi‐Zhong Ge, Chenan Liu, Qi Zhang, Hailun Xie, Guo‐Tian Ruan, Shiqi Lin, Xin Zheng, Yue Chen, Heyang Zhang, Mengmeng Song, Xiaowei Zhang, Chunlei Hu, Xiangrui Li, Ming Yang, Xiaoyue Liu, Li Deng, Hanping Shi · 发表于：BMC Medicine · 年份：2023 · DOI：10.1186/s12916-023-03225-7 · 被引用次数：74 · 研究领域：Nutrition and Health in Aging、Inflammatory Biomarkers in Disease Prognosis、Nutritional Studies and Diet

BACKGROUND: Malnutrition is associated with poor overall survival (OS) in breast cancer patients; however, the most predictive nutritional indicators for the prognosis of patients with breast cancer are not well-established. This study aimed to compare the predictive effects of common nutritional indicators on OS and to refine existing nutritional indicators, thereby identifying a more effective nutritional evaluation indicator for predicting the prognosis in breast cancer patients. METHODS: This prospective study analyzed data from 776 breast cancer patients enrolled in the "Investigation on Nutritional Status and its Clinical Outcome of Common Cancers" (INSCOC) project, which was conducted in 40 hospitals in China. We used the time-dependent receiver operating characteristic curve (ROC), Kaplan-Meier survival curve, and Cox regression analysis to evaluate the predictive effects of several nutritional assessments. These assessments included the patient-generated subjective nutrition assessment (PGSGA), the global leadership initiative on malnutrition (GLIM), the controlling nutritional status (CONUT), the nutritional risk index (NRI), and the prognostic nutritional index (PNI). Utilizing machine learning, these nutritional indicators were screened through single-factor analysis, and relatively important variables were selected to modify the PNI. The modified PNI, termed the cholesterol-modified prognostic nutritional index (CPNI), was evaluated for its predictive effect on t...