Department of Urology, Tokyo Medical University, Tokyo, Japan.
J Urol. 2010 Sep;184(3):873-8. doi: 10.1016/j.juro.2010.05.028.
We investigated the prognostic significance of the neutrophil-to-lymphocyte ratio to predict recurrence in patients with nonmetastatic renal cell carcinoma.
We retrospectively reviewed the records of 192 patients with nonmetastatic renal cell carcinoma (T1-4N0M0) who underwent nephrectomy between 1986 and 2000. Mean followup was 93 months (range 6 to 232) months. We assessed the prognostic value of the pretreatment neutrophil-to-lymphocyte ratio, and other clinical and laboratory parameters on univariate and multivariate analysis.
Presentation mode, tumor stage, C-reactive protein, lymphocyte count and the neutrophil-to-lymphocyte ratio significantly correlated with recurrence-free survival on univariate analysis. The recurrence-free survival rate in patients with a neutrophil-to-lymphocyte ratio of less than 2.7 was 93.7% at 5 years and 79.8% at 10 years, significantly higher than the 77.9% and 58.4%, respectively, in patients with a ratio of 2.7 or greater (p = 0.0205). Multivariate analysis revealed that T stage and the neutrophil-to-lymphocyte ratio were independent predictors of recurrence. The 10-year survival rate in patients at low risk (T2 or less and neutrophil-to-lymphocyte ratio less than 2.7), intermediate risk (T2 or less and ratio 2.7 or greater, or T3 or greater and ratio less than 2.7) and high risk (T3 or greater and ratio 2.7 or greater) was 82.0%, 63.6% and 33.0%, respectively, which were significantly different.
An increased pretreatment neutrophil-to-lymphocyte ratio is an independent predictor of recurrence. The combination of T stage and the neutrophil-to-lymphocyte ratio can be used to stratify recurrence risk in patients with nonmetastatic renal cell carcinoma.
我们研究中性粒细胞与淋巴细胞比值（NLR）对预测非转移性肾细胞癌（RCC）患者复发的预后意义。
我们回顾性分析了 192 例 1986 年至 2000 年间接受肾切除术的非转移性肾细胞癌（T1-4N0M0）患者的记录。中位随访时间为 93 个月（范围 6 至 232）。我们在单因素和多因素分析中评估了预处理 NLR 及其他临床和实验室参数的预后价值。
在单因素分析中，表现方式、肿瘤分期、C 反应蛋白、淋巴细胞计数和 NLR 与无复发生存显著相关。NLR<2.7 的患者 5 年无复发生存率为 93.7%，10 年无复发生存率为 79.8%，显著高于 NLR≥2.7 的患者（分别为 77.9%和 58.4%，p=0.0205）。多因素分析显示 T 分期和 NLR 是复发的独立预测因素。低危（T2 或更低且 NLR<2.7）、中危（T2 或更低且 NLR≥2.7，或 T3 或更高且 NLR<2.7）和高危（T3 或更高且 NLR≥2.7）患者的 10 年生存率分别为 82.0%、63.6%和 33.0%，差异有统计学意义。
术前 NLR 升高是复发的独立预测因素。T 分期和 NLR 的联合可用于分层非转移性肾细胞癌患者的复发风险。
