Colakerol Aykut, Sahin Sergen, Yazar Ramazan Omer, Temiz Mustafa Zafer, Yuruk Emrah, Kandirali Engin, Semercioz Atilla, Muslumanoglu Ahmet Yaser
Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey.
J Kidney Cancer VHL. 2023 Feb 3;10(1):9-14. doi: 10.15586/jkcvhl.v10i1.259. eCollection 2023.
This study aimed to investigate the predictive role of serum C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) on renal mass biopsy outcomes. A total of 71 patients with suspected kidney masses who underwent renal mass biopsy procedure between January 2017 and January 2021 were retrospectively evaluated. Pathological results after the procedure were obtained and pre-procedural serum CRP and NLR levels were extracted from the patients' data. The patients were grouped into benign and malignant pathology groups according to the histopathology results. The parameters were compared between the groups. Diagnostic role of the parameters in terms of sensitivity, specificity, and positive and negative predictive values was also determined. Additionally, Pearson correlation analysis, and univariate and multivariate cox proportional hazard regression analyses were also performed to investigate the above association with tumor diameter and pathology results, respectively. At the end of the analyses, a total of 60 patients had malignant pathology on histopathological investigations of the mass biopsy specimens, whereas the remaining 11 patients had a benign pathological diagnosis. Significantly higher CRP and NLR levels were detected in the malignant pathology group. The parameters positively correlated with the malignant mass diameter, as well. Serum CRP and NLR determined the malignant masses before the biopsy with sensitivity and specificity of 76.6 and 81.8%, and 88.3 and 45.4%, respectively. Moreover, univariate and multivariate analyses showed that serum CRP level had a significant predictive value for malignant pathology (HR: 0.998, 95% CI: 0.940-0.967, P < 0.001 and HR: 0.951, 95% CI: 0.936-0.966, P < 0.001, respectively). In conclusion, serum CRP and NLR levels were significantly different in patients with malignant pathology after renal mass biopsy compared to the patients with benign pathology. Serum CRP level, in particular, diagnosed malignant pathologies with acceptable sensitivity and specificity values. Additionally, it had a substantial predictive role in determining the malign masses prior the biopsy. Therefore, pre-biopsy serum CRP and NLR levels may be used to predict the diagnostic outcomes of renal mass biopsy in clinical practice. Further studies with larger cohorts can prove our findings in the future.
本研究旨在探讨血清C反应蛋白（CRP）和中性粒细胞与淋巴细胞比值（NLR）对肾脏肿块活检结果的预测作用。回顾性评估了2017年1月至2021年1月期间接受肾脏肿块活检的71例疑似肾脏肿块患者。获取术后病理结果，并从患者数据中提取术前血清CRP和NLR水平。根据组织病理学结果将患者分为良性和恶性病理组。比较两组之间的参数。还确定了这些参数在敏感性、特异性以及阳性和阴性预测值方面的诊断作用。此外，分别进行了Pearson相关分析以及单因素和多因素Cox比例风险回归分析，以研究上述与肿瘤直径和病理结果的关联。分析结束时，在对肿块活检标本的组织病理学检查中，共有60例患者为恶性病理，而其余11例患者为良性病理诊断。恶性病理组中检测到的CRP和NLR水平显著更高。这些参数也与恶性肿块直径呈正相关。血清CRP和NLR在活检前对恶性肿块的诊断敏感性和特异性分别为76.6%和81.8%，以及88.3%和45.4%。此外，单因素和多因素分析表明，血清CRP水平对恶性病理具有显著的预测价值（HR：0.998，95%CI：0.940 - 0.967，P < 0.001；HR：0.951，95%CI：0.936 - 0.966，P < 0.001）。总之，与良性病理患者相比，肾脏肿块活检后恶性病理患者的血清CRP和NLR水平存在显著差异。特别是血清CRP水平以可接受的敏感性和特异性值诊断恶性病理。此外，它在活检前确定恶性肿块方面具有重要的预测作用。因此，活检前血清CRP和NLR水平可用于预测临床实践中肾脏肿块活检的诊断结果。未来更大样本量的进一步研究可以证实我们的发现。
