Selvi Ismail, Basar Halil
Department of Urology, Karabuk University Training and Research Hospital, Karabuk, Turkey.
Department of Urology, University of Health Science Turkey, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):53-61. doi: 10.14744/SEMB.2019.95770. eCollection 2021.
We aimed to investigate the predictive value of additional parameters for distinguishing benign-malign tumors and to prevent the loss of nephrons in small (≤4 cm) solid renal masses.
The data of 56 patients underwent partial or radical nephrectomy between September 2009 and December 2017 due to diagnosis of localized renal cell carcinoma were retrospectively analyzed. Demographic datas, histopathological tumor types, neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), red blood cell distribution width (RDW), mean platelet volume (MPV), the Framingham risk score and its components, postoperative follow-up results were recorded. Patients were divided into two groups as benign and malign.
Among 56 patients with a median age of 60 (min: 35-max: 74) years, 13 patients had benign and 43 patients had malign pathologies. MLR (p=0.011), NLR (p=0.032), PLR (p=0.006), MPV (p=0.025), eGFR (p=0.019) and the Framingham score (p=0.008) were significantly higher in malign group. Among the components constituting the Framingham score, only presence of smoking (p=0.032), presence of hypertension (p=0.041) and total cholesterol values (p=0.021) were significantly higher. In multivariate analysis, NLR>2.02 (OR: 7.184, p=0.037), PLR>109.65 (OR: 12.692, p=0.002), MPV>3.44 (OR: 10.543, p=0.046) and Framingham score >10.5 (OR: 12.287, p=0.007) were found as predictive factors for distinguishing small solid renal masses concerning malignancy.
We think that NLR, PLR, MPV and the Framingham scores may be used in the clinical evaluation of small solid renal masses. In this way, we may prevent the unnecessary loss of nephrons in benign masses with suspicion of malignancy.
我们旨在研究额外参数对鉴别良恶性肿瘤的预测价值，并防止小（≤4 cm）实性肾肿块中肾单位的丢失。
回顾性分析2009年9月至2017年12月间因诊断为局限性肾细胞癌而接受部分或根治性肾切除术的56例患者的数据。记录人口统计学数据、组织病理学肿瘤类型、中性粒细胞/淋巴细胞比值（NLR）、单核细胞/淋巴细胞比值（MLR）、血小板/淋巴细胞比值（PLR）、红细胞分布宽度（RDW）、平均血小板体积（MPV）、弗雷明汉风险评分及其组成部分、术后随访结果。患者分为良性和恶性两组。
56例患者中位年龄为60岁（最小：35岁 - 最大：74岁），其中13例为良性病变，43例为恶性病变。恶性组的MLR（p = 0.011）、NLR（p = 0.032）、PLR（p = 0.006）、MPV（p = 0.025）、估算肾小球滤过率（eGFR）（p = 0.019）和弗雷明汉评分（p = 0.008）显著更高。在构成弗雷明汉评分的各组成部分中，只有吸烟（p = 0.032）、高血压（p = 0.041）的存在以及总胆固醇值（p = 0.021）显著更高。在多变量分析中，发现NLR>2.02（比值比：7.184，p = 0.037）、PLR>109.65（比值比：12.692，p = 0.002）、MPV>3.44（比值比：10.543，p = 0.046）和弗雷明汉评分>10.5（比值比：12.287，p = 0.007）是鉴别小实性肾肿块恶性程度的预测因素。
我们认为NLR、PLR、MPV和弗雷明汉评分可用于小实性肾肿块的临床评估。通过这种方式，我们可以防止疑似恶性的良性肿块中肾单位的不必要丢失。
