论文部分内容阅读
目的:评价术前外周血中性粒/淋巴细胞比率(NLR)与非转移性肾癌(T1~T4N0M0)术后生存的相关性。方法:回顾性分析2005年12月~2011年12月间在徐州医学院附属医院接受手术治疗的327例非转移性肾癌患者的临床资料:患者术前1天行血常规检查,进而获得NLR值。以此分析NLR与非转移性肾癌术后生存的相关性。再按NLR最佳截点将患者分为高NLR组和低NLR组,以χ2检验分析NLR与各临床病理因素的相关关系。通过Kaplan-Meier法比较NLR分组对生存时间的影响,应用Log-rank进行检验。应用单因素和多因素Cox回归模型检测NLR对于总生存率和无病生存率的独立预测的意义。结果:327例非转移性肾癌患者外周血NLR为2.72±2.25。根据受试者工作曲线(ROC),1.7为NLR最佳截点。NLR与肿瘤大小存在统计学相关(χ2=5.050,P=0.025),与病理类型、pT分期均不存在统计学相关。NLR高低分组对于总生存率(χ2=7.339,P=0.007)和无病生存率(χ2=6.419,P=0.011)的影响均具有统计学意义。多因素分析显示术前NLR对于总生存率(HR=1.674,95%CI=1.103~2.539,P=0.015)及无病生存率(HR=1.714,95%CI=1.092~2.691,P=0.019)具有独立预测的意义。结论:术前高NLR提示非转移性肾癌患者生存较差,有助于评估患者预后,可为制订个体化治疗措施提供参考。
Objective: To evaluate the correlation between preoperative peripheral blood neutrophil / lymphocyte ratio (NLR) and postoperative survival in non-metastatic renal cell carcinoma (T1 ~ T4N0M0). Methods: The clinical data of 327 patients with non-metastatic renal cell carcinoma who underwent surgery in the Affiliated Hospital of Xuzhou Medical College from December 2005 to December 2011 were retrospectively analyzed. The patients underwent routine blood tests one day before surgery to obtain NLR value. In order to analyze the correlation between NLR and postoperative survival of non-metastatic renal cell carcinoma. The patients were divided into high NLR group and low NLR group according to the best NLR cutoff point. The relationship between NLR and clinicopathological factors was analyzed by χ2 test. The impact of NLR grouping on survival time was compared by Kaplan-Meier method and Log-rank test was used. Univariate and multivariate Cox regression models were used to determine the significance of NLR in independent prognosis of overall and disease-free survival. Results: The NLR of 327 patients with non-metastatic renal cell carcinoma was 2.72 ± 2.25. According to the receiver operating curve (ROC), 1.7 is the best NLR cut-off point. There was a statistically significant correlation between NLR and tumor size (χ2 = 5.050, P = 0.025), but not with pathological type and pT staging. The effect of NLR level on total survival (χ2 = 7.339, P = 0.007) and disease-free survival (χ2 = 6.419, P = 0.011) were statistically significant. Multivariate analysis showed that preoperative NLR was significantly associated with overall survival (HR = 1.674, 95% CI = 1.103-2.539, P = 0.015) and disease free survival (HR = 1.714, 95% CI = 1.092-2.691, P = 0.019) It has the significance of independent prediction. CONCLUSION: Preoperative high NLR suggests that patients with non-metastatic renal cell carcinoma have poor survival and are helpful to evaluate the prognosis of patients. It may provide a reference for the development of individualized treatment measures.