Xu Kehan, Li Jialin, Hu Mengzi, Zhang Hao, Yang Jian, Gong Haiyi, Li Bo, Wan Wei, Xiao Jianru
Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, People's Republic of China.
Department of Orthopedics, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, People's Republic of China.
Cancer Manag Res. 2020 Jan 7;12:59-70. doi: 10.2147/CMAR.S228570. eCollection 2020.
The purpose of this retrospective study was to identify preoperative inflammatory biomarkers and clinical parameters and evaluate their prognostic significance in patients with spinal metastasis from clear cell renal cell carcinoma (CCRCC).
Correlations of overall survival (OS) with traditional clinical parameters and inflammatory indicators including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), albumin-globulin ratio (AGR), and C-reactive protein to albumin ratio (CRP/Alb ratio) were analyzed in 95 patients with spinal metastasis from CCRCA using the Kaplan-Meier method to identify potential prognostic factors. Factors with P values ≤ 0.1 were subjected to multivariate analysis by Cox regression analysis. P values ≤ 0.05 were considered statistically significant.
The 95 patients included in this study were followed up by a mean of 48.8 months (median 51 months; range 6-132 months), during which 21 patients died, with a death rate of 22.1%. The statistical results indicated that patients with total piecemeal spondylectomy (TPS), targeted therapy, NLR < 3.8 and PLR < 206.9 had a significantly longer OS rate.
TPS and targeted therapy could significantly prolong the OS of patients with spinal metastasis from CCRCC. In addition, NLR and PLR are robust and convenient prognostic indicators that have a discriminatory ability superior to other inflammatory biomarkers.
本回顾性研究旨在确定术前炎症生物标志物和临床参数,并评估其在透明细胞肾细胞癌(CCRCC)脊柱转移患者中的预后意义。
采用Kaplan-Meier法分析95例CCRCA脊柱转移患者的总生存期(OS)与传统临床参数及炎症指标的相关性,这些指标包括中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)、白蛋白与球蛋白比值(AGR)以及C反应蛋白与白蛋白比值(CRP/Alb比值),以确定潜在的预后因素。P值≤0.1的因素通过Cox回归分析进行多因素分析。P值≤0.05被认为具有统计学意义。
本研究纳入的95例患者平均随访48.8个月(中位数51个月;范围6 - 132个月),期间21例患者死亡,死亡率为22.1%。统计结果表明,接受整块椎体次全切除术(TPS)、靶向治疗、NLR < 3.8且PLR < 206.9的患者OS率显著更长。
TPS和靶向治疗可显著延长CCRCC脊柱转移患者的OS。此外,NLR和PLR是可靠且便捷的预后指标,其鉴别能力优于其他炎症生物标志物。