Zapała Łukasz, Kunc Michał, Sharma Sumit, Biernat Wojciech, Radziszewski Piotr
Clinic of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005 Warsaw, Poland.
Department of Pathomorphology, Medical University of Gdansk, 80-214 Gdańsk, Poland.
Diagnostics (Basel). 2021 Nov 21;11(11):2159. doi: 10.3390/diagnostics11112159.
The purpose of the study was to determine the influence of lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) values on the prognosis in patients with renal cell carcinoma (RCC) and venous tumor thrombus. The respective data of 91 patients treated with radical surgery in the years 2012-2021 in 2 tertiary referral urological centers were retrieved from local medical databases. Mean calculated 3-year overall survival (OS) reached 70% (mean follow-up 35.3 months). The association between lower LMR and the presence of tumor necrosis ( = 0.0004) was observed. Amongst systemic inflammatory markers, only LMR was selected as the sensitive marker predicting death with a calculated cut-off value of 2.53. OS was decreased in patients presenting with low LMR when compared to the high LMR group (39% vs. 82%, = 0.0011). Neither NLR nor PLR were associated with survival rates. In multivariate analysis, LMR was identified as the independent prognostic factor (HR = 0.20, 95% CI 0.07-0.55, = 0.001). Low values of LMR (<2.53) are independently connected with poorer OS in patients with RCC and coexisting tumor thrombus. The incorporation of the hematological variables into the prognostic model greatly increased its accuracy in predicting survival in the distinctive subpopulation of patients with RCC.
本研究的目的是确定淋巴细胞与单核细胞比值（LMR）、血小板与淋巴细胞比值（PLR）以及中性粒细胞与淋巴细胞比值（NLR）值对肾细胞癌（RCC）合并静脉瘤栓患者预后的影响。从当地医学数据库中检索了2012年至2021年在2家三级转诊泌尿外科中心接受根治性手术治疗的91例患者的相关数据。计算得出的3年总生存率（OS）平均为70%（平均随访35.3个月）。观察到较低的LMR与肿瘤坏死的存在之间存在关联（P = 0.0004）。在全身炎症标志物中，只有LMR被选为预测死亡的敏感标志物，计算得出的临界值为2.53。与高LMR组相比，低LMR患者的OS降低（39%对82%，P = 0.0011）。NLR和PLR均与生存率无关。在多变量分析中，LMR被确定为独立的预后因素（HR = 0.20，95%CI 0.07 - 0.55，P = 0.001）。LMR值低（<2.53）与RCC合并肿瘤栓子患者较差的OS独立相关。将血液学变量纳入预后模型大大提高了其在预测RCC患者独特亚群生存方面的准确性。
