Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Onodera's Prognostic Nutritional Index is a novel and useful prognostic marker for gastrointestinal stromal tumors
Hao Wang, Ying-Ying Xu, Jun You, Wen-Qing Hu, Shao-Feng Wang, Ping Chen, Fan Yang, Lei Shi, Wei Zhao, Liang Zong
Hao Wang, Ping Chen, Lei Shi, Wei Zhao, Department of Gastrointestinal Surgery, Northern Jiangsu People’s Hospital, Clinical Medical College, Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Ying-Ying Xu, Department of General Surgery, Yizheng People’s Hospital, Clinical Medical College, Yangzhou University, Yangzhou 211400, Jiangsu Province, China
Jun You, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen 361005, Fujian Province, China
Wen-Qing Hu, Liang Zong, Department of Gastrointestinal Surgery, Changzhi People’s Hospital, The Affiliated Hospital of Changzhi Medical College, Changzhi 046000, Shanxi Province, China
Shao-Feng Wang, Department of Digestive Internal Medicine, Changzhi People’s Hospital, The Affiliated Hospital of Changzhi Medical College, Changzhi 046000, Shanxi Province, China
Fan Yang, Department of Central Laboratory, Changzhi People’s Hospital, The Affiliated Hospital of Changzhi Medical College, Changzhi 046000, Shanxi Province, China
Author contributions: Xu YY, Wang H, and Zong L designed the research; Wang H, You J, Hu WQ, Wang SF, and Chen P performed the research; Shi L, Yang F, and Zhao W analyzed the data; Xu YY and Wang H wrote the paper and contributed equally to this study.
Supported by Health Commission of Shanxi Province, No. 2020130 and No. 2020TD27; and the Science and Technology Planning Project of Yangzhou City, No. YZ2018092.
Institutional review board statement: This study was approved by the Ethics Committee of Northern Jiangsu People’s Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Liang Zong, MD, PhD, Professor, Research Associate, Department of Gastrointestinal Surgery, Changzhi People’s Hospital, The Affiliated Hospital of Changzhi Medical College, No. 502 Changxing Middle Road, Luzhou District, Changzhi 046000, Shanxi Province, China. 250537471@qq.com
Received: March 18, 2021
Peer-review started: March 18, 2021
First decision: June 3, 2021
Revised: June 17, 2021
Accepted: August 13, 2021
Article in press: August 13, 2021
Published online: October 27, 2021
BACKGROUND
Immunoinflammatory markers such as the peripheral blood neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have gained considerable attention as prognostic markers in gastrointestinal stromal tumors (GISTs).
AIM
To assess the prognostic value of Onodera’s Prognostic Nutritional Index (OPNI) for GISTs.
METHODS
All patients who had undergone surgical resection for a primary, localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.
RESULTS
A total of 235 GISTs were identified and included for analysis under our inclusion criteria. Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker, and the OPNI was associated with the primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 51.30; hazard ratio = 5.852; 95% confidence interval: 1.072–31.964; P = 0.0414) was associated with worse RFS. The 2- and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%, respectively, whereas 100% and 98.41% were achieved by the patients with a high OPNI.
CONCLUSION
The preoperative OPNI is a novel and useful prognostic marker for GISTs.
Core Tip: Immunoinflammatory markers such as the peripheral blood neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio have gained considerable attention as prognostic markers in gastrointestinal stromal tumors (GISTs). Here we conducted the first investigation of the prognostic value of Onodera’s Prognostic Nutritional Index (OPNI) for GISTs. A total of 235 GISTs were identified and included for analysis under our inclusion criteria. Our study shown that the 2- and 5-year recurrence-free survival rates of the patients with a low OPNI were 92.83% and 76.22%, respectively, whereas 100% and 98.41% were achieved by the patients with a high OPNI, which demonstrated that the preoperative OPNI is a novel and useful prognostic marker for GISTs.
