Zhang Gui-Ming, Zhu Yao, Gu Wei-Jie, Zhang Hai-Liang, Shi Guo-Hai, Ye Ding-Wei
Department of Urology, Fudan University, Shanghai Cancer Center, No. 270, Dong'an Rd, Shanghai, 200032, People's Republic of China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Int J Clin Oncol. 2016 Apr;21(2):373-378. doi: 10.1007/s10147-015-0894-4. Epub 2015 Sep 3.
The neutrophil-to-lymphocyte ratio (NLR) is associated with clinical outcomes of various cancers. This study aimed to evaluate whether pretreatment NLR can be used as a prognostic factor in patients with metastatic renal cell carcinoma (mRCC) receiving targeted therapy.
In this single-center retrospective study, the Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival (OS) of 373 mRCC patients receiving targeted therapy. The survival outcomes of patients with high (≥ 2.2) and low (< 2.2) pretreatment NLRs were compared by log-rank test, and Cox proportional hazard regression model was used to compare OS and PFS between groups.
The overall median PFS and OS times for all 373 patients were 18.4 and 34.3 months, respectively. Patients with high NLRs had significantly shorter median OS (28.8 vs 410 months, P = 0.005) and PFS (15.4 vs 23.9 months, P = 0.001) than those with low NLRs. After adjusting for confounding variables, each unit increase of NLR was associated with a 40 % increase in mortality (hazard ratio [HR] 1.391; 95 % confidence interval [CI] 1.022-1.894; P = 0.036). High NLR was also an independent predictor of poor PFS (HR 1.544; 95 % CI 1.166-2.045; P = 0.002).
Pretreatment NLR may be an independent prognostic factor for mRCC patients who are receiving targeted therapy.
中性粒细胞与淋巴细胞比值（NLR）与多种癌症的临床预后相关。本研究旨在评估治疗前NLR是否可作为接受靶向治疗的转移性肾细胞癌（mRCC）患者的预后因素。
在这项单中心回顾性研究中，采用Kaplan-Meier法评估373例接受靶向治疗的mRCC患者的无进展生存期（PFS）和总生存期（OS）。通过对数秩检验比较治疗前NLR高（≥2.2）和低（<2.2）的患者的生存结局，并使用Cox比例风险回归模型比较组间的OS和PFS。
373例患者的总体中位PFS和OS时间分别为18.4个月和34.3个月。NLR高的患者的中位OS（28.8个月对41.0个月，P = 0.005）和PFS（15.4个月对23.9个月，P = 0.001）显著短于NLR低的患者。在调整混杂变量后，NLR每增加一个单位，死亡率增加40%（风险比[HR]1.391；95%置信区间[CI]1.022 - 1.894；P = 0.036）。高NLR也是PFS差的独立预测因素（HR 1.544；95%CI 1.166 - 2.045；P = 0.002）。
治疗前NLR可能是接受靶向治疗的mRCC患者的独立预后因素。
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