Senior Department of Urology, the Third Medical Center of PLA General Hospital, Beijing, China.
Medical School of Chinese PLA, Beijing, China.
World J Surg Oncol. 2023 Jul 21;21(1):211. doi: 10.1186/s12957-023-03110-w.
Inflammation is considered to be one of the driving factors of cancer, and chronic inflammation plays a crucial role in tumor growth and metastasis. The aim of this study was to examine the predictive value of preoperative inflammatory biomarkers for overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC), including preoperative neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and aspartate aminotransferase-to-lymphocyte ratio (ALR), a novel inflammatory biomarker.
This study included 198 patients with mRCC from a single center from 2006 to 2022. The optimal cut-off levels for the three biomarkers were derived using the receiver operating characteristic curve (ROC). Cox univariate and multivariate analyses were used to assess independent prognostic inflammatory biomarkers. Finally, independent prognostic inflammatory biomarkers were incorporated into the prognostic model to establish a nomogram to predict the postoperative survival of patients with mRCC.
The area under the ROC curve for NLR, LMR, and ALR, respectively, is 0.71 (CI: 0.635-0.784), 0.68 (CI: 0.604-0.755), and 0.75 (CI: 0.680-0.819). The optimal LMR, NLR, and ALR cut-off levels as evaluated by the ROC curve were 3.836, 3.106, and 68.056, respectively. Patients with NLR and ALR higher than the cut-off level and LMR lower than the cut-off level had a significant relationship with OS. Multivariate analysis revealed that tumor necrosis, lower LMR, and higher ALR were independent risk factors for OS. In addition, a nomogram that includes independent prognostic inflammatory biomarkers can accurately predict the OS in patients with mRCC.
ALR and LMR are independent risk factors for the prognosis of individuals with mRCC. By monitoring ALR and LMR postoperatively, the prognosis of patients with mRCC can be better evaluated.
炎症被认为是癌症的驱动因素之一，慢性炎症在肿瘤生长和转移中起着关键作用。本研究旨在探讨术前炎症生物标志物对转移性肾细胞癌（mRCC）患者总生存期（OS）的预测价值，包括术前中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）和天冬氨酸转氨酶与淋巴细胞比值（ALR），这是一种新的炎症生物标志物。
本研究纳入了 2006 年至 2022 年期间来自单一中心的 198 例 mRCC 患者。使用受试者工作特征曲线（ROC）得出三个生物标志物的最佳截断值。Cox 单因素和多因素分析用于评估独立的预后炎症生物标志物。最后，将独立的预后炎症生物标志物纳入预后模型，建立预测 mRCC 患者术后生存的列线图。
NLR、LMR 和 ALR 的 ROC 曲线下面积分别为 0.71（CI：0.635-0.784）、0.68（CI：0.604-0.755）和 0.75（CI：0.680-0.819）。ROC 曲线评估的最佳 LMR、NLR 和 ALR 截断值分别为 3.836、3.106 和 68.056。NLR 和 ALR 高于截断值且 LMR 低于截断值的患者与 OS 有显著关系。多因素分析显示肿瘤坏死、较低的 LMR 和较高的 ALR 是 OS 的独立危险因素。此外，包含独立预后炎症生物标志物的列线图可以准确预测 mRCC 患者的 OS。
ALR 和 LMR 是 mRCC 个体预后的独立危险因素。通过监测术后 ALR 和 LMR，可以更好地评估 mRCC 患者的预后。
