Validation of the pretreatment derived neutrophil-lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma.
Validation of the pretreatment derived neutrophil-lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma.
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DOI：
10.1038/bjc.2014.180
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发表时间：
2014-05-13
影响因子：
8.8
通讯作者：
Hutterer, G. C.
中科院分区：
文献类型：
--
作者：
Dalpiaz, O.;Pichler, M.;Mannweiler, S.;Hernandez, J. M. Martin;Stojakovic, T.;Pummer, K.;Zigeuner, R.;Hutterer, G. C.
关键词：
中性粒细胞和白细胞计数的组合指数，称为衍生中性粒细胞-淋巴细胞比率（dNLR），最近被提出作为各种癌症类型的生存预后指标。我们研究了dNLR在欧洲上尿路上皮癌（UTUC）患者中的预后作用。回顾性评估了1990年至2012年间在单一三级学术中心手术的171例非转移性UTUC患者的数据。采用Kaplan-Meier法评估癌症特异性（CSS）和总生存期（OS）。为了评估dNLR的独立预后意义，采用多变量比例cox回归模型。此外，通过Harrell’s concordance index （c-index）进一步确定dNLR对多元模型预测准确性的影响。中位随访期为31个月。增加的dNLR与较短的CSS （log-rank P=0.004）以及较短的OS （log-rank P=0.002）有统计学意义上的显著相关。多变量分析发现dNLR是CSS（风险比，HR=1.16, 95%可信区间，CI= 1.01-1.35， P=0.045）和OS （HR=1.21, 95% CI= 1.09-1.34， P<0.001）的独立预测因子。无dNLR时OS的多变量模型c指数估计为0.68，加入dNLR后的c指数估计为0.73。与预处理dNLR较低的患者相比，可以预测预处理dNLR较高的患者随后在UTUC手术后显示出更高的癌症特异性和总体死亡率。因此，这一综合指标应被视为未来潜在的预后生物标志物。
The value of a combined index of neutrophil and white cell counts, named derived neutrophil–lymphocyte ratio (dNLR), has recently been proposed as a prognosticator of survival in various cancer types. We investigated the prognostic role of the dNLR in a large European cohort of patients with upper tract urothelial carcinoma (UTUC). Data from 171 non-metastatic UTUC patients, operated between 1990 and 2012 at a single tertiary academic centre, were evaluated retrospectively. Cancer-specific- (CSS) as well as overall survival (OS) were assessed using the Kaplan–Meier method. To evaluate the independent prognostic significance of the dNLR, multivariate proportional Cox-regression models were applied. Additionally, the influence of the dNLR on the predictive accuracy of the multivariate model was further determined by Harrell's concordance index (c-index). The median follow-up period was 31 months. An increased dNLR was statistically significantly associated with shorter CSS (log-rank P=0.004), as well as with shorter OS (log-rank P=0.002). Multivariate analysis identified dNLR as an independent predictor for CSS (hazard ratio, HR=1.16, 95% confidence interval, CI=1.01–1.35, P=0.045), as well as for OS (HR=1.21, 95% CI=1.09–1.34, P<0.001). The estimated c-index of the multivariate model for OS was 0.68 without dNLR and 0.73 when dNLR was added. Patients with a high pretreatment dNLR could be predicted to show subsequently higher cancer-specific- as well as overall mortality after surgery for UTUC compared with those with a low pretreatment dNLR. Thus, this combined index should be considered as a potential prognostic biomarker in future.
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