Department of Urology & Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.
Clin Chim Acta. 2018 Oct;485:26-32. doi: 10.1016/j.cca.2018.06.019. Epub 2018 Jun 15.
We evaluated the prognostic impact of the preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy treatment.
A total of 717 patients were identified between 2003 and 2016. The cutoff value of NLR was set as 2.5. Kaplan-Meier method and Cox's proportional hazards regression models were utilized to analyze the association between NLR and oncological outcomes.
The median follow-up was 42 months. The results suggested that preoperative elevated NLR was associated with worse pathological features. Also, patients with NLR ≥ 2.5 had worse survival outcomes than those with NLR <2.5 (all P < .001). Multivariate cox analysis revealed that NLR ≥ 2.5 was an independent predictor of worse cancer-specific survival, disease recurrence-free survival, metastasis-free survival and overall survival (HR 1.95, 95%CI: 1.42-2.69, P < .001; HR 1.70, 95%CI: 1.31-2.20, P < .001; HR 1.67, 95%CI: 1.22-2.31, P = .002; and HR 1.88, 95%CI: 1.42-2.50, P < .001; respectively). Notably, NLR was ascertained to be a useful prognostic predictor in patients with high-grade disease, but not in those with low-grade UTUC.
Preoperative elevated NLR was associated with worse outcomes in patients with UTUC. Subgroup analysis affirmed that NLR was a useful predictor in patients with high-grade disease, but not in those with low-grade UTUC.
我们评估了根治性肾输尿管切除术治疗后上尿路上皮癌（UTUC）患者术前中性粒细胞与淋巴细胞比值（NLR）的预后影响。
共纳入 2003 年至 2016 年间的 717 例患者。NLR 的截断值设定为 2.5。采用 Kaplan-Meier 方法和 Cox 比例风险回归模型分析 NLR 与肿瘤学结局之间的关系。
中位随访时间为 42 个月。结果表明，术前 NLR 升高与较差的病理特征相关。此外，NLR≥2.5 的患者的生存结局较 NLR<2.5 的患者更差（均 P<0.001）。多因素 Cox 分析显示，NLR≥2.5 是癌症特异性生存、无疾病复发生存、无转移生存和总生存较差的独立预测因素（HR 1.95，95%CI：1.42-2.69，P<0.001；HR 1.70，95%CI：1.31-2.20，P<0.001；HR 1.67，95%CI：1.22-2.31，P=0.002；HR 1.88，95%CI：1.42-2.50，P<0.001）。值得注意的是，NLR 被确定为高级别疾病患者的有用预后预测因子，但在低级别 UTUC 患者中则不然。
术前 NLR 升高与 UTUC 患者的不良结局相关。亚组分析证实，NLR 是高级别疾病患者的有用预测因子，但在低级别 UTUC 患者中则不然。
