Dalpiaz Orietta, Luef Theresa, Seles Maximilian, Stotz Michael, Stojakovic Tatjana, Pummer Karl, Zigeuner Richard, Hutterer Georg C, Pichler Martin
Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, Graz A-8036, Austria.
Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 25, Graz A-8036, Austria.
Br J Cancer. 2017 Jan 3;116(1):85-90. doi: 10.1038/bjc.2016.393. Epub 2016 Dec 1.
We investigated the prognostic value of the pretreatment-derived neutrophil-lymphocyte ratio (dNLR) and original NLR in relation to the commonly used inflammation marker C-reactive protein (CRP) in a large cohort of patients with clear cell renal cell carcinoma (RCC).
Clinicopathological data from 587 consecutive non-metastatic clear cell RCC patients, operated between 2000 and 2010 at a single tertiary academic center, were evaluated retrospectively. Patients were categorised according to a cutoff value derived from receiver operating curve analysis. Overall (OS), cancer-specific (CSS) as well as metastasis-free survival (MFS) were assessed using the Kaplan-Meier method and multivariate Cox proportional models were applied. Spearman's rank correlation coefficient tested the association between dNLR and other markers of the systemic inflammatory response.
The significant correlation between pretreatment NLR and dNLR was strong (ρ=0.84), whereas between dNLR and CRP it was weak (ρ=0.18). In multivariate analyses, dNLR achieved independent predictor status regarding CSS (P=0.037) and MFS (P=0.041), whereas CRP was confirmed as independent predictor of OS (P=0.010), CSS (P=0.039) and MFS (P=0.005), respectively. The NLR failed to reach independent predictor status regarding OS, CSS and MFS when CRP was included into the multivariate model.
In the cohort studied, an elevated (⩾10.0) pretreatment CRP level and elevated dNLR (>2) were robust independent predictors of CSS and MFS. Our data suggest that CRP might be superior to both NLR and dNLR.
我们在一大群肾透明细胞癌（RCC）患者中，研究了治疗前衍生的中性粒细胞与淋巴细胞比值（dNLR）和原始NLR与常用炎症标志物C反应蛋白（CRP）相关的预后价值。
回顾性评估了2000年至2010年在单个三级学术中心接受手术的587例连续非转移性肾透明细胞癌患者的临床病理数据。根据受试者工作曲线分析得出的临界值对患者进行分类。使用Kaplan-Meier方法评估总生存期（OS）、癌症特异性生存期（CSS）以及无转移生存期（MFS），并应用多变量Cox比例模型。Spearman等级相关系数检验了dNLR与全身炎症反应其他标志物之间的关联。
治疗前NLR与dNLR之间的显著相关性很强（ρ=0.84），而dNLR与CRP之间的相关性较弱（ρ=0.18）。在多变量分析中，dNLR在CSS（P=0.037）和MFS（P=0.041）方面获得了独立预测指标地位，而CRP分别被确认为OS（P=0.010）、CSS（P=0.039）和MFS（P=0.005）的独立预测指标。当将CRP纳入多变量模型时，NLR在OS、CSS和MFS方面未能达到独立预测指标地位。
在所研究的队列中，治疗前CRP水平升高（⩾10.0）和dNLR升高（>2）是CSS和MFS的有力独立预测指标。我们的数据表明，CRP可能优于NLR和dNLR。
