Validation of the pre-treatment neutrophil-lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients.
Validation of the pre-treatment neutrophil-lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients.
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DOI：
10.1038/bjc.2013.28
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发表时间：
2013-03-05
影响因子：
8.8
通讯作者：
Zigeuner R
中科院分区：
文献类型：
--
作者：
Pichler M;Hutterer GC;Stoeckigt C;Chromecki TF;Stojakovic T;Golbeck S;Eberhard K;Gerger A;Mannweiler S;Pummer K;Zigeuner R
嗜中性粒细胞-淋巴细胞比率（NLR）已被提议作为全身炎症反应的指标。几项研究表明，NLR增加对不同类型癌症患者的生存率有负面影响。然而，以前的小规模研究结果显示，在非转移性肾细胞癌（RCC）患者的不同临床终点方面，其预后意义的结果相互矛盾。因此，我们研究的目的是在一个大的RCC患者队列中验证NLR的预后意义。回顾性评价了2000年至2010年在单一中心手术的678例连续非转移性透明细胞RCC患者的数据。使用Kaplan-Meier方法评估癌症特异性、无转移以及总生存期（OS）。为了评估NLR的独立预后意义，对所有三个不同的终点应用多变量考克斯回归模型。NLR对Leibovich预后评分预测准确性的影响由Harrell一致性指数确定。多变量分析将NLR增加确定为总体预后的独立预后因素。（风险比（HR）=1.59，95%置信区间（CI）=1.10-2.31，P=0.014），但对于癌症特异性（HR=1.59，95%CI =0.84-2.99，P=0.148），无转移生存率（HR=1.39，95%CI =0.85-2.28，P=0.184）也无统计学意义。使用Leibovich风险评分估计的一致性指数为0.79，添加NLR时为0.81。关于患者的OS，NLR增加是一个独立的风险因素，可能反映了重度心血管和其他合并症的风险较高。将NLR添加到已建立的预后模型（如Leibovich预后评分）中可能会提高其预测能力。
The neutrophil–lymphocyte ratio (NLR) has been proposed as an indicator of systemic inflammatory response. Several studies suggest a negative impact of increased NLR for patient's survival in different types of cancer. However, previous findings from small-scale studies revealed conflicting results about its prognostic significance with regard to different clinical end points in non-metastatic renal cell carcinoma (RCC) patients. Therefore, the aim of our study was the validation of the prognostic significance of NLR in a large cohort of RCC patients. Data from 678 consecutive non-metastatic clear cell RCC patients, operated between 2000 and 2010 at a single centre, were evaluated retrospectively. Cancer-specific, metastasis-free, as well as overall survival (OS) were assessed using the Kaplan–Meier method. To evaluate the independent prognostic significance of NLR, multivariate Cox regression models were applied for all three different end points. Influence of the NLR on the predictive accuracy of the Leibovich prognosis score was determined by Harrell's concordance index. Multivariate analysis identified increased NLR as an independent prognostic factor for overall (hazard ratio (HR)=1.59, 95% confidence interval (CI)=1.10–2.31, P=0.014), but not for cancer-specific (HR=1.59, 95% CI=0.84–2.99, P=0.148), nor for metastasis-free survival (HR=1.39, 95% CI=0.85–2.28, P=0.184). The estimated concordance index was 0.79 using the Leibovich risk score and 0.81 when NLR was added. Regarding patients' OS, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. Adding the NLR to well-established prognostic models such as the Leibovich prognosis score might improve their predictive ability.
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影响因子：
3.4
作者：
Kocyigit, Ismail;Eroglu, Eray;Utas, Cengiz
通讯作者：
Utas, Cengiz
影响因子：
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作者：
Kattan, MW;Reuter, V;Russo, P
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Russo, P
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Jensen, Hanne Krogh;Donskov, Frede;von der Maase, Hans
通讯作者：
von der Maase, Hans
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作者：
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通讯作者：
Gibson, Charles Michael
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作者：
Gibson, Patrick H.;Croal, Bernard L.;Hillis, Graham S.
通讯作者：
Hillis, Graham S.