Agizamhan Sezim, Qu Feng, Liu Ning, Sun Jing, Xu Wei, Zhang Lihua, Guo Hongqian, Gan Weidong
Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China.
Department of Oncology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
BMC Urol. 2018 Jun 11;18(1):60. doi: 10.1186/s12894-018-0374-z.
The preoperative neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CRP/Alb ratio) and platelet-to-lymphocyte ratio (PLR) have been demonstrated to predict the clinical outcome of various human cancer, including renal cell carcinoma(RCC). The aim of our study was to explore the prognostic values of these ratios in patients with Xp11.2 translocation/TFE3 gene fusions renal cell carcinoma (Xp11.2 tRCC).
A retrospective multicentre study was performed in 82 Xp11.2 tRCC patients who underwent radical or partial nephrectomy. The optimal cutoff values of the NLR, CRP/Alb ratio and PLR were determined by the receiver operating characteristic (ROC) analysis. The impact of the NLR, CRP/Alb ratio and PLR, as well as other clinicopathological characteristics, on disease-free survival (DFS) and overall survival (OS) were evaluated using the univariate and multivariate Cox regression analyses.
The optimal cutoff values of the NLR, CRP/Alb ratio and PLR were set at 2.45, 140 and 0.08, respectively, according to the ROC analysis. Univariate analyses showed that the NLR, CRP/Alb ratio and PLR all were associated with DFS of Xp11.2 tRCC patients (P < 0.001, P = 0.005 and P = 0.001, respectively) and OS of Xp11.2 tRCC patients (P = 0.016, P = 0.003 and P = 0.014, respectively). Multivariate analysis indicated that the NLR was independently associated with DFS of Xp11.2 tRCC patients (hazard ratio [HR]: 4.25; 95% confidence interval [95% CI]: 1.19-15.18; P = 0.026) along with age (P = 0.004), the pT status (P < 0.001) and the pN status (P < 0.019), and the NLR (HR: 26.26; 95% CI: 1.44-480.3; P = 0.028) also was independently associated with OS in patients with Xp11.2 tRCC, along with age (P = 0.016) and a tumour thrombus (P = 0.007).
Overall, relatively high NLRs, CRP/Alb ratios and PLRs were associated with a poor prognosis of Xp11.2 tRCC patients; among of them, only the NLR independently predicted the progression of Xp11.2 tRCC, and the NLR may help to identify patients with high metastasis or relapse risk.
术前中性粒细胞与淋巴细胞比值（NLR）、C反应蛋白与白蛋白比值（CRP/Alb比值）以及血小板与淋巴细胞比值（PLR）已被证明可预测包括肾细胞癌（RCC）在内的各种人类癌症的临床结局。我们研究的目的是探讨这些比值在Xp11.2易位/TFE3基因融合肾细胞癌（Xp11.2 tRCC）患者中的预后价值。
对82例行根治性或部分肾切除术的Xp11.2 tRCC患者进行了一项回顾性多中心研究。通过受试者工作特征（ROC）分析确定NLR、CRP/Alb比值和PLR的最佳截断值。使用单因素和多因素Cox回归分析评估NLR、CRP/Alb比值和PLR以及其他临床病理特征对无病生存期（DFS）和总生存期（OS）的影响。
根据ROC分析，NLR、CRP/Alb比值和PLR的最佳截断值分别设定为2.45、140和0.08。单因素分析显示，NLR、CRP/Alb比值和PLR均与Xp11.2 tRCC患者的DFS相关（P分别<0.001、P = 0.005和P = 0.001）以及与Xp11.2 tRCC患者的OS相关（P分别= 0.016、P = 0.003和P = 0.014）。多因素分析表明，NLR与Xp11.2 tRCC患者的DFS独立相关（风险比[HR]：4.25；95%置信区间[95%CI]：1.19 - 15.18；P = 0.026），同时与年龄（P = 0.004）、pT状态（P < 0.001）和pN状态（P < 0.019）有关，并且NLR（HR：26.26；95%CI：1.44 - 480.3；P = 0.028）也与Xp11.2 tRCC患者的OS独立相关，同时与年龄（P = 0.016）和肿瘤血栓（P = 0.007）有关。
总体而言，相对较高的NLR、CRP/Alb比值和PLR与Xp11.2 tRCC患者的不良预后相关；其中，只有NLR可独立预测Xp11.2 tRCC的进展，并且NLR可能有助于识别具有高转移或复发风险的患者。
