ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1649334
The Relationship Between Prognostic Nutritional Index (PNI) and Its Components (Albumin and Lymphocyte Count) and All-Cause Mortality in Lung Cancer Patients: A Hospital-Based Study with Database External Validation
Provisionally accepted
- 1Lanzhou University, lanzhou, China
- 2Department of Thoracic Surgery, Second Hospital of Lanzhou University, lanzhou, China
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The potential of the Prognostic Nutritional Index (PNI), which is determined by albumin and lymphocyte count, as a prognostic marker was explored in this hospital - based study with database external validation. Cox proportional hazards regression was used for univariate and multivariate analysis, followed by variance inflation factor (VIF) testing. Kaplan - Meier (KM) curves were plotted and log - rank tests performed. Restricted cubic spline (RCS) models were applied to assess non - linear relationships. In the hospital - based study, Cox single - factor analysis showed PNI, albumin, and lymphocyte count were associated with mortality. After VIF testing and multivariate adjustment, PNI remained significantly related to mortality. KM curves demonstrated significant survival differences across PNI tertiles (log - rank P < 0.001). RCS analysis indicated a non - linear relationship between PNI and mortality risk. External validation using the NHANES database consistently showed PNI was linked to mortality, with significant survival differences in KM analysis (log - rank P = 0.011) and a non - linear relation in RCS. The study confirms that PNI and its components albumin and lymphocyte count are significantly associated with all - cause mortality in lung cancer patients, highlighting PNI as a promising prognostic indicator.
Keywords: PNI, NHANES, Cox proportional hazards regression, RCS, Vif
Received: 19 Jun 2025; Accepted: 03 Sep 2025.
Copyright: © 2025 Qin, Li, Hou and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cheng Wang, Department of Thoracic Surgery, Second Hospital of Lanzhou University, lanzhou, China
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