Teishima Jun, Ohara Shinya, Sadahide Kousuke, Fujii Shinsuke, Kitano Hiroyuki, Kobatake Kohei, Shinmei Shunsuke, Hieda Keisuke, Inoue Shogo, Hayashi Tetsutaro, Mita Koji, Matsubara Akio
Department of Urology, Institute of Biomedical and Health Sciences, Integrated Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Urology, Hiroshima-City Asa Citizens Hospital, Hiroshima, Japan.
Can Urol Assoc J. 2017 May;11(5):E207-E214. doi: 10.5489/cuaj.4106. Epub 2017 May 9.
The aim of our present study was to investigate the impact of the pretreatment neutrophil-to-lymphocyte ratio (NLR) on the antitumour effects of targeted agents in patients with metastatic renal cell carcinoma (mRCC).
The NLRs in 283 cases of molecular targeted therapy for mRCC were measured before starting the prescription of the molecular targeted agent. The significance of pretreatment NLR on the site of metastatic organs and on progression-free survival (PFS) in each case was analyzed.
Metastases other than lung, which is defined as "extrapulmonary metastasis," were observed in 190 cases (67.1%). The median of pretreated NLR was 2.39 (0.49-68.7). In 97 of the 283 cases, pretreated NLR was 3.0 or higher. These cases were categorized as the high NLR group and the rest as the low NLR group. When the cases with extrapulmonary metastasis were investigated and classified based on their pretreated NLR, 50% PFS in the high NLR and low NLR groups was 6.7 months and 12 months (p=0.0001), respectively. Multivariate analysis revealed that high NLR (>3.0) was an independent predictive factor for PFS in the cases with extrapulmonary metastasis (hazard ratio 2.762; p<0.0001), while there was no significant difference between PFS in the high and low NLR groups in cases with no extrapulmonary metastasis (p=0.3457).
Our data indicate that the predictive significance of the NLR in mRCC cases involving targeted therapy depends on the metastatic organs. NLR is an independent predictive factor of PFS in cases of mRCC with extrapulmonary metastasis treated with targeted therapy.
我们目前研究的目的是探讨治疗前中性粒细胞与淋巴细胞比值（NLR）对转移性肾细胞癌（mRCC）患者靶向药物抗肿瘤效果的影响。
在开始使用分子靶向药物治疗前，对283例接受mRCC分子靶向治疗的患者进行NLR检测。分析治疗前NLR对各病例转移器官部位及无进展生存期（PFS）的意义。
190例（67.1%）观察到除肺以外的转移，定义为“肺外转移”。治疗前NLR的中位数为2.39（0.49 - 68.7）。在283例病例中，97例治疗前NLR为3.0或更高。这些病例被归类为高NLR组，其余为低NLR组。当根据治疗前NLR对肺外转移病例进行调查和分类时，高NLR组和低NLR组的50% PFS分别为6.7个月和12个月（p = 0.0001）。多因素分析显示，高NLR（>3.0）是肺外转移病例PFS的独立预测因素（风险比2.762；p < 0.0001），而在无肺外转移的病例中，高NLR组和低NLR组的PFS无显著差异（p = 0.3457）。
我们的数据表明，NLR在涉及靶向治疗的mRCC病例中的预测意义取决于转移器官。NLR是接受靶向治疗的肺外转移mRCC病例PFS的独立预测因素。
