Tsujino Takuya, Komura Kazumasa, Ichihashi Atsushi, Tsutsumi Takeshi, Matsunaga Tomohisa, Yoshikawa Yuki, Maenosono Ryoichi, Okita Kyohei, Takai Tomoaki, Oide Rintaro, Minami Koichiro, Uehara Hirofumi, Taniguchi Kohei, Hirano Hajime, Nomi Hayahito, Ibuki Naokazu, Takahara Kiyoshi, Inamoto Teruo, Azuma Haruhito
Department of Urology, Osaka Medical College, Osaka 569-8686, Japan.
Translational Research Program, Osaka Medical College, Osaka 569-8686, Japan.
Oncotarget. 2017 Nov 25;8(66):110311-110325. doi: 10.18632/oncotarget.22688. eCollection 2017 Dec 15.
The combination of platelet count and neutrophil to lymphocyte ratio (COP-NLR) has been shown to provide prognostic information in several cancers, whereas its prognostic value in renal cell carcinoma (RCC) has not been reported. The objective of the present study was to examine the preoperative prognostic value of the COP-NLR in patients with localized RCC undergoing nephrectomy.
The record of 268 patients, who underwent nephrectomy due to a diagnosis of RCC at our institute was analyzed in the study. The cut-off value of platelet count and NLR were defined by receive operating characteristic (ROC) analysis and the areas under the curve (AUC). Patients with both an increased platelet count (> 310×10/l) and an elevated NLR (> 3.85) were assigned to the score 2, and patients with one or neither of these indicators were assigned to the score 1 or 0, respectively. The impact of the COP-NLR and other clinicopathological characteristics on overall survival (OS) and recurrence-free survival (RFS) were evaluated using the univariate and multivariate Cox regression analysis.
The median follow-up duration after surgical resection was 60 months. Multivariate analysis using the 10 clinicopathological findings selected by univariate analyses demonstrated that the preoperative COP-NLR was an independent prognostic factor for OS (HR: 2.32, 95%CI: 1.22 to 4.26, p=0.011) and RFS (HR: 1.91, 95%CI: 1.02 to 3.53, p=0.044).
The findings of the current study suggested that the preoperative COP-NLR is an independent prognostic indicator of OS and RFS for patients with localized RCC.
血小板计数与中性粒细胞与淋巴细胞比值（COP-NLR）的联合已被证明能为多种癌症提供预后信息，而其在肾细胞癌（RCC）中的预后价值尚未见报道。本研究的目的是探讨COP-NLR在接受肾切除术的局限性RCC患者中的术前预后价值。
本研究分析了我院268例因诊断为RCC而接受肾切除术患者的记录。通过接受操作特征（ROC）分析和曲线下面积（AUC）确定血小板计数和NLR的临界值。血小板计数升高（>310×10⁹/L）且NLR升高（>3.85）的患者被归为2分，有其中一项指标或两项指标均无的患者分别被归为1分或0分。使用单因素和多因素Cox回归分析评估COP-NLR和其他临床病理特征对总生存期（OS）和无复发生存期（RFS）的影响。
手术切除后的中位随访时间为60个月。使用单因素分析选出的10项临床病理结果进行多因素分析表明，术前COP-NLR是OS（HR：2.32，95%CI：1.22至4.26，p=0.011）和RFS（HR：1.91，95%CI：1.02至3.53，p=0.044）的独立预后因素。
本研究结果表明，术前COP-NLR是局限性RCC患者OS和RFS的独立预后指标。
