术前血钙及中性粒细胞淋巴细胞计数比对肾透明细胞癌预后的价值分析

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摘要目的:分析术前外周血血钙水平和中性粒细胞淋巴细胞计数比(NLR)对肾癌预后判断的价值。方法:回顾2011全年经手术治疗的173例肾透明细胞癌患者的临床资料,分析影响肾透明细胞癌患者预后的相关因素,并在此基础上比较血钙下降组和正常组患者的生存情况。结果:单因素分析显示,术前血钙水平、NLR、术后肿瘤TNM分期及Furhman核分级是影响肾透明癌患者生存期的影响因素(均P<0.05);但多因素Cox回归分析提示,只有术后TNM分期和Furhman核分级为肾癌预后独立影响因素。进一步对血钙进行Kaplan-Meier生存曲线分析显示,下降组与正常组3年生存率分别为73.2%和93.6%,两组间差异有统计学意义(P<0.01)。结论:术前血钙水平和NLR可作为肾透明细胞癌预后的有效指标。

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	王瀚锋
	段鹏
	顾良友
	雷振伟
	杨凯锐
	张旭

关键词 ：肾透明细胞癌, 中性粒细胞淋巴细胞计数比, 低钙血症, 预后分析

Abstract：Objective: To investigate the validation of preoperative blood calcium level and neutrophil/lymphocyte ratio (NLR) as prognostic indicators for clear cell renal cell carcinoma (ccRCC) after surgery. Methods: Data from 173 patients with ccRCC, treated within the whole year of 2011 at a single center, were evaluated retrospectively. Preoperative NLR, the blood calcium level, TNM and Furhman staging were analyzed by using univariate analysis and Cox multivariate regression analysis respectively. Furthermore, according to the different preoperative blood calcium levels, the Kaplan-Meier method was used to compare the postoperative survivals between declined group and normal group. Results: Univariate analysis revealed that the high NLR, low blood calcium level, high TNM staging and high Furhman staging were identified as relative factors of overall survival (P<0.05 for all). However, Multivariate analysis showed that TNM staging and Furhman staging were the independent prognostic factors (P<0.05). The 3-year survival rate in declined group and normal group was 73.2% and 93.6% respectively (P<0.01). Conclusions: We confirmed a significant association of preoperative elevated NLR and declined blood calcium level with poor clinical outcome in ccRCC patients. Our result indicate that preoperative NLR and blood calcium level could represent useful markers for patients' stratification in ccRCC management.

Key words： clear cell renal cell carcinoma neutrophil/lymphocyte ratio hypocalcaemia prognostic analysis

收稿日期: 2015-05-22

ZTFLH:

R737.11

通讯作者: 张旭 E-mail: xzhang@foxmail.com

引用本文:

王瀚锋,段鹏,顾良友,雷振伟,杨凯锐,张旭. 术前血钙及中性粒细胞淋巴细胞计数比对肾透明细胞癌预后的价值分析[J]. 微创泌尿外科杂志, 2015, 4(4): 224-228.
Wang Hanfeng, Duan Peng, Gu Liangyou, Lei Zhenwei, Yang Kairui, Zhang Xu. Prognostic value of preoperative blood calcium level and neutrophil-lymphocyte ratio for clear cell renal cell carcinoma. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2015, 4(4): 224-228.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract796.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2015/V4/I4/224

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