术前外周血中性粒细胞/淋巴细胞比值与肾癌临床病理特点及预后关系的研究  

The Relationship Between Preoperative Neutrophil to Lymphocyte Ratio and Clinicopathological Features and Prognosis of Patients with Renal Cancer

作　　者：姚大勇[1] 史策[2] 夏舜尧[1] 兰文家 刘天伯[3] 修有成[1] 

机构地区：[1]哈尔滨医科大学附属第一医院泌尿外科三病房,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第一医院血液内科,黑龙江哈尔滨150001 [3]哈尔滨医科大学附属肿瘤医院妇科,黑龙江哈尔滨150081

出　　处：《现代生物医学进展》2016年第32期6379-6383,6209,共6页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81502225);国家博士后基金项目(2015M581480)

摘　　要：目的：分析术前外周血中性粒细胞/淋巴细胞比值（NLR）与肾癌临床病理特征及预后的关系。方法：回顾性分析2007年1月~2011年12月在哈尔滨医科大学附属第一医院泌尿外科接受根治性手术且病理证实为非转移肾癌患者的临床病例及随访资料。根据ROC曲线确定NLR最佳截点,并以此截点将患者分为高NLR组和低NLR组。分析两组间临床病理特征的差异。应用Kaplan-Meier法、Log-rank法进行单因素生存分析,应用Cox风险回归模型进行多因素生存分析。结果：460例患者中,男性306例,女性154例,中位年龄56岁。NLR平均值为2.34±1.77,中位值为2.45。根据ROC曲线分析,当NLR为2.5时,曲线下面积（AUC=0.628,p〈0.001）最大。以此截点将患者分为高NLR（≥2.5）组154例,低NLR（〈2.5）组306例。两组间年龄、Fuhrman分期、T分期上差异具有统计学意义（p〈0.05）。单因素生存分析显示Fuhrman、T分期、NLR值是肾癌预后因素,Cox多因素回归分析显示T分期、NLR值是肾癌的独立预后因素。结论：术前外周血中性粒细胞/淋巴细胞比值（NLR）是肾癌患者预后不良的独立危险因素。Objective： To evaluate the relationship between preoperative peripheral blood neutrophil to lymphocyte ratio（NLR）and clinicopathologic variables and prognosis of patients with renal cancer. Methods： The clinical pathological and followed-up data of460 cases of patients with pathologically confirmed renal cancer and underwent radical nephrectomy were retrospectively analyzed.According to ROC curves, the optimal cut-off value of NLR was obtained and patients were divided into high NLR group and low NLR group. And the clinicopathologic factors within two groups were analyzed. The survival of patients were analyzed by Kaplan-Meier,Log-rank and Cox proportional hazards regresion analysis. Results： Of all 460 patients, there were 306 male and 154 female with a median age of 56 years old. The mean NLR value was 2.34 ±1.77, and median value was 2.45. According to ROC analysis, the best cutoff value was 2.5（AUC=0.628, P〈0.001） and patients were divided into high NLR group（154 patients）, and low NLR group（306patients）. The differences of age, Fuhrman classification, T classification between two groups was statistically significant（p〈0.05）.Univariate analysis showed that Fuhrman classification, T classification and NLR value were prognostic factors. Multivariate analysis also showed that T classification and NLR value were independent prognostic factors. Conclusions： Preoperative peripheral blood neutrophil to lymphocyte ratio（NLR） was an independent poor prognostic factor of patients with renal cancer.

关 键 词：肾癌 中性粒细胞/淋巴细胞计数 预后 

分 类 号：R737.11[医药卫生—肿瘤]