It's convenient and practical! Do you know this prognostic indicator of renal cell carcinoma?

Being able to accurately predict the prognosis of cancer patients is critical
for clinicians to develop the most appropriate treatment strategy and follow-up plan.

Prognostic Nutrition Index (PNI), a new method for assessing a patient's immune and nutritional status based on serum lymphocyte counts and albumin levels, has been used in several studies to predict the prognosis
of patients with renal cell carcinoma (RCC).
However, the impact of PNI on the prognosis of RCC needs to be explored
in depth due to differences in sample size, patient characteristics, and other factors in existing studies.
To this end, Korean researchers conducted this meta-analysis to evaluate the diagnostic accuracy and application value
of PNI as a prognostic factor for RCC based on the available data.

Based on the systematic review and the Meta-Analysis Priority Report Item (PRISMA) statement, the investigators conducted a systematic and comprehensive search of relevant literature in the PubMed, Web of Science, Cochrane Library and EMBASE databases, structured research questions according to PICO principles and screened
the literature.
PNI values were calculated using formula 10× albumin concentration (g/dL) + 0.
005× lymphocyte count (/mm³), and their sensitivity, specificity, combined subject operating characteristic curve (SROC) and area under the curve (AUC)
were evaluated.

The final meta-analysis included 11 studies
involving a total of 7296 people with RCC.
Pooled analysis of PNI data on the prognostic value of RCC showed a sensitivity of 0.
733 (95% CI 0.
651 to 0.
802), specificity of 0.
615 (95% CI 0.
528 to 0.
695), diagnostic odds ratio (DOR) of 4.
382 (95% CI 3.
148 to 6.
101), and AUC of 0.
72 (95% CI 0.
68 to 0.
76).

Fig.
1 Forest plot of sensitivity and specificity of PNI for the prognostic value of RCC

Subgroup analysis showed that the presence of metastasis and PNI cut-off values (≥50 vs <50) affected the diagnostic accuracy<b10> of PNI in RCC.
Multivariate meta-regression showed a significant difference in sensitivity and specificity between PNI and non-metastatic RCC groups (p=0.
035).

Table 1 Univariate and multivariate meta-regression analysis results

This study showed that PNI as a prognostic indicator of RCC demonstrated good diagnostic accuracy, especially in
metastatic RCC.