ANALISIS MARKER INFLAMASI TERHADAP STATUS NUTRISI PADA PASIEN KANKER KEPALA DAN LEHER (Kajian terhadap Ratio Neutrofil/Limfosit (NLR) dan Prognostic Nutritional Index (PNI))

Introduction : Malnutrition in Head and Neck Cancer (HNC) patients should be considered as an important factor to improve quality of life and survival rate. Screening and diagnosing malnutrition should be done as soon as possible hence nutritional intervention can be given to reduce morbidity and mortality. Prognostic Nutritional Index (PNI) is a feasible, simple, and affordable tool that can be used to reflect nutritional and immunological conditions by using serum albumin and lymphocyte count.
Aim : The study aims to determine the relationship between PNI in patients with Head and Neck Cancer (HNC).
Methods : A cross-sectional study of 85 HNC patients was conducted between January 2017 to January 2020 using medical record in Dr. Wahidin Sudirohusodo Hospital. Nutritional status was evaluated using Subjective Global Assessment (SGA), total energy requirement was measured using Harris Benedict equation and energy intake calculation were done. Severe malnutrition was defined by SGA Score C and moderate malnutrition was defined by SGA Score B. Inflammatory marker and outcome were assessed based on PNI by calculating serum albumin and absolute lymphocyte count. Data were analyzed using SPSS version 25.0.
Result : The data of 85 patients were analyzed, the highest age range is 40-60 years and most of them were male. The majority of patients were severely malnourished (54.1%) and moderately malnourished (45.9%). The PNI score for severely malnourished HNC patients were significantly lower than moderately malnourished HNC patients with p value = 0.0005. Energy requirement in severe malnutrition patients were significantly higer than moderate malnutrition, energy intake was lower in severely malnourished patients. Moreover, no significant differences between gender and age-group with nutritional status. No significant differences were also found between HNC type with gender, age-group, PNI, serum albumin level, total energy requirement and energy intake.
Conclusion : PNI was significantly associated with nutritional status in head and neck cancer patients.