The prognostic value of preoperative neutrophil-to-lymphocyte ratio in patients with upper tract urothelial carcinoma
The prognostic value of preoperative neutrophil-to-lymphocyte ratio in patients with upper tract urothelial carcinoma
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DOI：
10.1016/j.cca.2018.06.019
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发表时间：
2018-10-01
影响因子：
5
通讯作者：
Wei, Qiang
中科院分区：
文献类型：
--
作者：
Tan, Ping;Xu, Hang;Wei, Qiang
背景资料：我们评估了根治性肾输尿管切除术治疗后上尿路上皮癌（UTUC）患者术前嗜中性粒细胞与淋巴细胞比率（NLR）的预后影响。方法：2003年至2016年期间共确定了717例患者。NLR的临界值设定为2.5。采用Kaplan-Meier法和考克斯比例风险回归模型分析NLR与肿瘤预后的关系。结果表明，术前NLR升高与病理特征恶化相关。此外，NLR 2.5的患者的生存结局比NLR < 2.5的患者差（均P <0.001）。多变量考克斯分析显示NLR 2.5是癌症特异性生存率、无疾病复发生存率、无转移生存率和总生存率较差的独立预测因子（HR 1.95，95%CI：1.42-2.69，P < .001; HR 1.70，95%CI：1.31-2.20，P < .001; HR 1.67，95%CI：1.22-2.31，P = .002; HR 1.88，95%CI：1.42-2.50，P < .001;分别）。值得注意的是，NLR被确定为一个有用的预后预测高级别的疾病患者，但不是在那些低级别UTUC。结论：术前升高NLR与UTUC患者的预后较差。亚组分析证实，NLR是高级别疾病患者的有用预测因子，但不是低级别UTUC患者的预测因子。
Background: We evaluated the prognostic impact of the preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy treatment.Methods: A total of 717 patients were identified between 2003 and 2016. The cutoff value of NLR was set as 2.5. Kaplan-Meier method and Cox's proportional hazards regression models were utilized to analyze the association between NLR and oncological outcomes.Results: The median follow-up was 42 months. The results suggested that preoperative elevated NLR was associated with worse pathological features. Also, patients with NLR 2.5 had worse survival outcomes than those with NLR < 2.5 (all P < .001). Multivariate cox analysis revealed that NLR 2.5 was an independent predictor of worse cancer-specific survival, disease recurrence-free survival, metastasis-free survival and overall survival (HR 1.95, 95%Cl: 1.42-2.69, P < .001; HR 1.70, 95%CI: 1.31-2.20, P < .001; HR 1.67, 95%CI: 1.22-2.31, P = .002; and HR 1.88, 95%CI: 1.42-2.50, P < .001; respectively). Notably, NLR was ascertained to be a useful prognostic predictor in patients with high-grade disease, but not in those with low-grade UTUC.Conclusions: Preoperative elevated NLR was associated with worse outcomes in patients with UTUC. Subgroup analysis affirmed that NLR was a useful predictor in patients with high-grade disease, but not in those with low-grade UTUC.