Followup of Neutrophil-to-Lymphocyte Ratio and Recurrence of Clear Cell Renal Cell Carcinoma
Followup of Neutrophil-to-Lymphocyte Ratio and Recurrence of Clear Cell Renal Cell Carcinoma
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DOI：
10.1016/j.juro.2011.10.026
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发表时间：
2012-02-01
影响因子：
6.6
通讯作者：
Tachibana, Masaaki
中科院分区：
文献类型：
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作者：
Ohno, Yoshio;Nakashima, Jun;Tachibana, Masaaki
目的：治疗前中性粒细胞/淋巴细胞比率升高与包括肾癌在内的各种癌症的不良预后有关。材料与方法：我们回顾了250例非转移性肾透明细胞癌患者的临床病理资料，分析了手术前后中性粒细胞/淋巴细胞比率与无复发生存率的关系。结果：术前中性粒细胞/淋巴细胞比率等于或大于2.7者的10年无复发生存率显著低于中性粒细胞/淋巴细胞比率<2.7者(64.4%vs83.7%，p=0.0004)。术前比值大于等于2.7的患者可进一步分为两组，两组的预后有显著差异。术前中性粒细胞/淋巴细胞比值在2.7时或以上，术后中性粒细胞/淋巴细胞比值在2.7时以下者的10年无复发生存率明显低于术前、术后时中性粒细胞/淋巴细胞比值在2.7时以上者(52.0%比83.5%，P=0.0487)。后者与术前比率低于2.7的患者的83.7%相似。复发患者复发率明显高于术后(平均+/-SD2.82+/-1.63vs2.00+/-0.90，P=0.0090)。多因素分析显示，肿瘤大小、病理分期、中性粒细胞/淋巴细胞比值变化(术前、术后比值)是影响复发的独立因素。根据这3个显著变量将患者分为低、中、高三组，其中无复发生存率差异有统计学意义。结论：治疗后中性粒细胞/淋巴细胞比值变化是影响肾透明细胞癌复发的重要预后因素，与肿瘤大小、病理分期有关。
Purpose: An increase in the pretreatment neutrophil-to-lymphocyte ratio is associated with poor prognosis for various cancers, including renal cell carcinoma. However, the clinical implication of a posttreatment change in the neutrophil-to-lymphocyte ratio in patients with cancer remains unclear.Materials and Methods: We reviewed the records of 250 patients with nonmetastatic clear cell renal cell carcinoma and analyzed associations among clinicopathological variables, the preoperative and postoperative neutrophil-to-lymphocyte ratio, and recurrence-free survival.Results: The 10-year recurrence-free survival rate for patients with a preoperative neutrophil-to-lymphocyte ratio of 2.7 or greater was significantly lower than that for those with a ratio of less than 2.7 (64.4% vs 83.7%, p = 0.0004). When combined with the postoperative ratio, patients with a preoperative ratio of 2.7 or greater could be further divided into 2 groups with a significantly different prognosis. The 10-year recurrence-free survival rate for patients with a preoperative neutrophil-to-lymphocyte ratio of 2.7 or greater and postoperative ratio of less than 2.7 was significantly lower than that for those with a preoperative and postoperative ratio of 2.7 or greater (52.0% vs 83.5%, p = 0.0487). The latter was similar to the 83.7% for patients with a preoperative ratio of less than 2.7. In patients with recurrence the ratio at recurrence was significantly increased compared with the postoperative ratio (mean +/- SD 2.82 +/- 1.63 vs 2.00 +/- 0.90, p = 0.0090). Multivariate analysis showed that tumor size, pathological tumor stage and the neutrophil-to-lymphocyte ratio change (a combination of the preoperative and postoperative ratios) were independent predictors of recurrence. Using these 3 significant variables patients were stratified into low, intermediate and high risk groups, among which the recurrence-free survival rate significantly differed.Conclusions: The posttreatment neutrophil-to-lymphocyte ratio change was a significant prognostic factor for recurrence as well as tumor size and pathological tumor stage in patients with clear cell renal cell carcinoma.