外周血细胞联合胱抑素C对肾癌根治术后急性肾损伤及预后的评估价值  

Assessment Value of Peripheral Blood Cells Combined with Cystatin C on Acute Kidney Injury and Prognosis After Radical Nephrectomy for Renal Cancer

作　　者：刘沛[1] 韩广业[1] 张春锋 张冠英 宋伟航 LIU Pei;HAN Guangye;ZHANG Chunfeng(The First Affiliated Hospital of Xinxiang Medical Univercity,Xinxiang,453100)

机构地区：[1]新乡医学院第一附属医院,453100

出　　处：《实用癌症杂志》2025年第4期637-641,共5页The Practical Journal of Cancer

摘　　要：目的探究外周血细胞联合胱抑素C对肾癌根治术后急性肾损伤及预后的评估价值。方法收集113例肾癌患者资料,分析患者外周血细胞、胱抑素C水平在肾癌根治术前和术后24小时内的变化及在不同程度肾损伤患者中的水平,分析外周血细胞、胱抑素C水平与患者预后的关系,评估外周血细胞、胱抑素C联合诊断的效能。结果与同时间段对照组比较,观察组术后PLT、N、M、NLR、PLR、sCr和Cys-C水平偏高(P<0.05),L和LMR水平偏低(P<0.05);不同AKI分期患者PLT、N、L、M、NLR、PLR、LMR、sCr和Cys-C水平存在明显差异(P<0.01),其中PLT、N、M、NLR、PLR、sCr和Cys-C水平随着疾病严重程度增加而增加,L和LMR反之。将与OS相关的单因素进行多因素分析,N(HR=3.180,95%CI:1.715~5.897)、M(HR=1.579,95%CI:1.010~2.469)、PLR(HR=1.422,95%CI:1.027~1.969)、Cys-C(HR=1.76,95%CI:1.110~2.800)是肾癌预后的危险因素;NLR(HR=1.413,95%CI:1.043~1.915)是肾癌预后的保护因素。外周血、Cys-C单项诊断AKI及预后准确率较低,五项串联(预后)、八项串联(急性肾损伤)的准确率、灵敏度和特异性均高于并联。结论外周血细胞PLT、N、M、NLR、PLR和Cys-C水平随肾癌根治术后急性肾损伤严重程度增加而增加,L和LMR反之。此外,N、M、PLR、Cys-C是肾癌预后的危险因素,NLR是肾癌预后的保护因素。外周血细胞和Cys-C串联检测对急性肾损伤及预后评估的准确率最高。Objective To investigate the assessment value of peripheral blood cells combined with cystatin C on acute kidney injury and prognosis after radical surgery for renal cancer.Methods To collect the data of 113 kidney cancer patients,analyze the changes of peripheral blood cells and cystatin C levels in patients before and 24 hours after radical surgery for kidney cancer and in patients with different degrees of renal injury,analyze the relationship between peripheral blood cells and cystatin C levels and patients'prognosis,and evaluate the efficacy of the combination of peripheral blood cells and cystatin C in diagnosis.Results Compared with the control group in the same time period,the observation group had higher levels of PLT,N,M,NLR,PLR,sCr,and Cys-C(P<0.05),and lower levels of L and LMR(P<0.05)in the postoperative period;there was a significant difference in the levels of PLT,N,L,M,NLR,PLR,LMR,sCr,and Cys-C in the patients with different AKI stages(P<0.01),where PLT,N,M,NLR,PLR,sCr and Cys-C levels increased with increasing disease severity,and vice versa for L and LMR;single factors associated with OS were analyzed in a multifactorial analysis,N(HR=3.180,95%CI:1.715~5.897),M(HR=1.579,95%CI:1.010~2.469),PLR(HR=1.422,95%CI:1.027~1.969),Cys-C(HR=1.76,95%CI:1.110~2.800)were prognostic risk factors for renal cancer;NLR(HR=1.413,95%CI:1.043~1.915)was a prognostic protective factor for renal cancer;the accuracy of single test of N,M,NLR,PLR,and Cys-C was lower.Peripheral blood and Cys-C alone were less accurate in diagnosing AKI and prognosis,and the five-item tandem(prognosis)and eight-item tandem(acute kidney injury)were more accurate,sensitive,and specific than the parallel tandem.Conclusion Peripheral blood cell levels of PLT,N,M,NLR,PLR,and Cys-C increased with increasing severity of acute kidney injury after radical nephrocalcinosis,and vice versa for L and LMR.In addition,N,M,PLR,and Cys-C were prognostic risk factors and NLR was a prognostic protective factor for kidney cancer.Tandem testing of peripheral bl

关 键 词：外周血细胞 胱抑素C 肾癌 急性肾损伤 预后 

分 类 号：R737.11[医药卫生—肿瘤]