Clinical significance of preoperative peripheral blood neutrophil count in patients with non-metastatic upper urinary tract carcinoma
Clinical significance of preoperative peripheral blood neutrophil count in patients with non-metastatic upper urinary tract carcinoma
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DOI：
10.1007/s00345-012-0942-x
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发表时间：
2013-08-01
影响因子：
3.4
通讯作者：
Tachibana, Masaaki
中科院分区：
文献类型：
--
作者：
Hashimoto, Takeshi;Ohno, Yoshio;Tachibana, Masaaki
术前全身炎症标志物升高与多种癌症的不良预后相关。本研究的目的是评估术前全身炎症标志物对非转移性上尿路癌（UUTC）患者的预后意义。回顾性分析了 84 例接受肾输尿管切除术的非转移性 UUTC 患者的记录，并通过单因素和无复发生存率（RFS）分析了术前临床变量与无复发生存率（RFS）之间的关联。 多变量分析。单变量分析显示，临床肿瘤分期、中性粒细胞计数和中性粒细胞与淋巴细胞比率与 RFS 显着相关。多变量分析显示，临床 T 分期（风险比 [HR]，3.009；95% 置信区间 [CI]，1.149-9.321；p = 0.024）和中性粒细胞计数（HR，3.521；95% CI，1.423-9.108；p = 0.007）是 RFS 的独立预测因子。中性粒细胞计数 < 4,000/μL 的患者的 3 年 RFS 显着高于中性粒细胞计数为千分之 4,000 日元/μL 的患者（82.9 vs. 51.0 %，p = 0.004）。根据临床 T 分期（T2 或更低与 T3 或更高）和中性粒细胞计数（< 4,000 与千分之 4,000 日元/μL），将患者分为 3 组：低风险组、中风险组和高风险组。 3 组之间的 RFS 率显着不同 (p = 0.0005)。术前中性粒细胞计数是非转移性 UUTC 患者 RFS 的独立预测因子。根据中性粒细胞计数和临床 T 分期对患者进行分层可能对于术前患者咨询和识别可能适合新辅助化疗的预后不良患者很有价值。
Preoperative elevation of markers of systemic inflammation is associated with a poor outcome in several cancers. The purpose of this study was to evaluate the prognostic significance of preoperative systemic inflammatory markers in patients with non-metastatic upper urinary tract cancer (UUTC).The records of 84 patients with non-metastatic UUTC who had undergone nephroureterectomy were reviewed, and the associations between preoperative clinical variables and recurrence-free survival (RFS) were analyzed by univariate and multivariate analyses.Clinical tumor stage, neutrophil count, and neutrophil-to-lymphocyte ratio were significantly associated with RFS in univariate analysis. Multivariate analysis showed that clinical T stage (hazard ratio [HR], 3.009; 95 % confidence interval [CI], 1.149-9.321; p = 0.024) and neutrophil count (HR, 3.521; 95 % CI, 1.423-9.108; p = 0.007) were independent predictors of RFS. The 3-year RFS in patients with a neutrophil count < 4,000/mu L was significantly higher than that in patients with a neutrophil count a parts per thousand yen4,000/mu L (82.9 vs. 51.0 %, p = 0.004). Based on clinical T stage (T2 or less vs. T3 or greater) and neutrophil count (< 4,000 vs. a parts per thousand yen4,000/mu L), patients were stratified into 3 groups: low, intermediate, and high risk groups. RFS rates were significantly different between the 3 groups (p = 0.0005).Preoperative neutrophil count was an independent predictor of RFS in patients with non-metastatic UUTC. Stratification of patients based on neutrophil count and clinical T stage may be valuable for preoperative patient counseling and identifying patients with poor prognosis who may be candidates for neoadjuvant chemotherapy.