title: Influence of prognostic nutritional index and tumor markers on survival in gastric cancer surgery patients.
abstract: OBJECTIVE
  Blood analytes are easily used in routine clinical practice. Tumor markers (TMs) are useful in diagnosing, treating, and predicting prognosis of gastric cancer (GC). The prognostic nutritional index (PNI) was also recently found to be useful in predicting GC prognosis.
  
  
  METHODS
  The PNI and serum levels of CEA and CA19-9 of 453 patients with GC were measured to examine correlations between those levels and patients' prognoses.
  
  
  RESULTS
  Of the 453 patients, 84 (18.5%) were positive for CEA and/or CA19-9 and therefore considered positive for TMs. Prognosis of patients who were TM+ was significantly worse than for those who were TM-. Mean PNI was 48.2 (range 27.7-63.6). ROC analysis indicated that 46.7 was the optimal PNI cutoff value. Prognosis of patients in the PNILowgroup (<46.7) was significantly worse than in the PNIHighgroup (≥46.7). Prognosis of patients who were both TM+ and PNILowwas significantly worse than that of patients who were either TM+ or PNILowand those who were both TM- and PNIHigh. Multivariate analysis indicated that combination of TM and PNI was an independent prognostic indicator.
  
  
  CONCLUSIONS
  The combination of TM and PNI offers accurate information about a patient's prognosis.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan. sai10@med.tottori-u.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Saito
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kono
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Murakami
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Matsunaga
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Fukumoto
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Osaki
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015596:Nutrition Assessment; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen
keywords: Gastric cancer; PNI; Prognosis; Tumor marker