Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, Beijing, China.
Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, Beijing, China.
Clin Genitourin Cancer. 2017 Oct;15(5):582-590. doi: 10.1016/j.clgc.2017.04.001. Epub 2017 Apr 27.
We compared the prognostic significance of inflammatory and nutritional scores, including the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio in patients with renal cell carcinoma (RCC) undergoing nephrectomy.
We retrospectively analyzed the data from 1360 patients with RCC undergoing nephrectomy from 2001 to 2010. The PNI was calculated as the serum albumin level (g/L) + 5 × lymphocyte count (10/L). The receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values. The areas under the ROC curve (AUCs) were calculated to compare the predictive ability of the indexes. Univariate and multivariate analyses were used to identify the prognostic factors for overall survival (OS) and progression-free survival (PFS).
The median follow-up period after surgery was 67 months (range, 2-108 months). The PNI had the largest AUC for both OS and PFS. On univariate analysis, each index was associated with OS and PFS. On multivariate analysis, PNI, rather than other inflammatory and nutritional scores, remained as a risk factor for OS (hazard ratio [HR], 1.645; 95% confidence interval [CI], 1.153-2.348; 2P = .006) and PFS (HR, 1.705; 95% CI, 1.266-2.296; 2P < .001).
The preoperative PNI might be a good prognostic factor for both OS and PFS in RCC patients undergoing nephrectomy.
我们比较了炎症和营养评分，包括预后营养指数（PNI）、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值和淋巴细胞与单核细胞比值，这些评分在接受肾切除术的肾细胞癌（RCC）患者中的预后意义。
我们回顾性分析了 2001 年至 2010 年期间接受肾切除术的 1360 例 RCC 患者的数据。PNI 通过血清白蛋白水平（g/L）+5×淋巴细胞计数（10/L）计算得出。使用受试者工作特征（ROC）曲线分析确定截断值。计算 ROC 曲线下的面积（AUCs）以比较各指标的预测能力。使用单因素和多因素分析来确定总生存期（OS）和无进展生存期（PFS）的预后因素。
手术后的中位随访时间为 67 个月（范围，2-108 个月）。PNI 在 OS 和 PFS 方面具有最大的 AUC。在单因素分析中，每个指标均与 OS 和 PFS 相关。在多因素分析中，PNI 而不是其他炎症和营养评分，仍然是 OS（风险比 [HR]，1.645；95%置信区间 [CI]，1.153-2.348；2P=0.006）和 PFS（HR，1.705；95%CI，1.266-2.296；2P<0.001）的危险因素。
术前 PNI 可能是接受肾切除术的 RCC 患者 OS 和 PFS 的良好预后因素。
