ZHANG Zekai , WU Mingsheng , WANG Gaoxiang , WANG Yu , MEI Xinyu , WU Xianning , LIU Changqing , SUN Xiaohui , XU Meiqing , XIE Mingran
  • Department of Thoracic Surgery, The First Hospital Affiliated to the University of Science and Technology of China, Hefei, 230001, P. R. China;
XIE Mingran, Email: xmr1981@ustc.edu.cn
Esophageal squamous cell carcinoma; Naples prognostic score; controlling nutritional status; prognostic nutritional index; prognostic value; nutrition score; inflammatory response; immunonutrition
10.7507/1007-4848.202511036
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Objective To evaluate whether three preoperative nutritional scoring indices, the Naples prognostic score (NPS), controlling nutritional status (CONUT), and prognostic nutritional index (PNI), are associated with the clinicopathological characteristics and prognosis of patients with esophageal squamous cell carcinoma (ESCC). Methods A retrospective analysis was conducted on clinical data from ESCC patients who underwent surgical treatment in the Department of Thoracic Surgery at the First Hospital Affiliated to the University of Science and Technology of China between 2017 and 2019. Based on NPS, CONUT, and PNI scores, optimal cutoff values were determined using X-tile software to divide patients into a high-value group and a low-value group. Differences in clinicopathological characteristics between groups were compared. Survival analysis was performed using Kaplan-Meier method and log-rank test. Multivariate Cox proportional hazards model was used to analyze factors influencing overall survival (OS). The predictive performance of each nutritional index was evaluated by area under receiver operating characteristic curve (AUC). Differences in AUC values among ROC curves were compared using MedCalc software. Results A total of 606 ESCC patients were included, comprising 459 males and 147 females, with a mean age of (65.98±7.60) years. Univariate analysis showed that age, squamous cell carcinoma antigen level, NPS, CONUT, PNI, TNM stage, degree of differentiation, and tumor size were all risk factors affecting OS in ESCC patients (P<0.05). Multivariate analysis revealed that age, TNM stage, and NPS were independent risk factors for OS. Among the indices analyzed for prognostic efficacy via AUC values comparison, NPS demonstrated the highest AUC value (0.681) with statistically significant superiority over PNI and CONUT (P<0.05). Conclusion  Age, TNM stage, and NPS are independent risk factors affecting the OS of ESCC patients after surgery. Moreover, prognostic evaluation efficacy of NPS surpasses that of PNI and CONUT, indicating its potential as a significant indicator for predicting outcomes in ESCC patients.

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