The Relationship Between Preoperative Neutrophil Lymphocyte Ratio And Prognosis In Germ Cell Testicular Tumors

Purpose: To explore and analyze neutrophil lymphocyte ratio(NLR)in preoperative as markers of systemic inflammation in the prognosis of germ cell testicular tumors.Methods:115 germ cell testicular tumors patients treated with operation at The second hospital of tianjin medical university between January 2006 and December 2015 were retrospectively analyzed.All patients with histologically proven testicular germ cell tumors.On the basis of tumor types patients can be divided into two groups,with 62 seminoma patients and 53 nonseminoma patients.The preoperative neutrophillymphocyte ratio(NLR),TNM pathological stage,lymph node metastasis and overall disease survival(OS)were retrospectively analyzed.Through case statistics and analyzing the preoperative NLR values of the 115 patients enrolled,the median NLR was 2.56.Therefore,select 2.56 as the critical value.All patients were divided into high NLR group(≥2.56)and the low NLR group(< 2.56).To explore(1)the relationship between the preoperative NLR level and the overall survival time(OS)of testicular germ cell tumor patients;(2)the relationship between the level of preoperative NLR and the pathological stage of patients with testicular germ cancer;(3)in the presence of lymph node metastasis or not this two subgroups,the correlation between the preoperative NLR level and the overall disease duration(OS)was investigated.Kaplan Meier-survival analysis to compare the research object of the cumulative survival,survival curve comparison between using the Log rank test conducted univariate survival analysis,using four table chi-square analysis between the NLR size and pathological staging.Result:Among 115 patients with testicular germ cell tumors,64 were in the high-NLR group,10 of them were dead,and 51 were in the low-NLR group,including 2 deaths.The survival rates of the two groups were 84.4% and 96.1%,respectively.There was no significant difference in overall survival(P=0.065);analysis was performed in two subgroups of seminomas and divided seminoma,of which,in the group of 62 seminoma,there were 38 cases in the high NLR group and 4 died.In the low NLR group,there were 24 cases and 1 death.The survival rates of the two groups were 89.5% and 95.8% respectively.There was no significant difference in the prognosis of testicular seminocytomas with NLR(P>0.05).Among the 53 non-seminomas,there were 26 cases in the high NLR group,6 deaths,27 cases in the low NLR group,and 1 death.The survival rates of the two groups were 76.9% and 96.3%,respectively.The survival rate of non-seminoma patients was significantly different(P<0.05).(2)According to TNM tumor stage,there were 49 T1 patients,including 19 in high NLR group and 30 in low NLR group;66 patients in T2 or higher stage were included,including 45 in high NLR group and 21 in low NLR group.There was a significant difference in the corresponding T stage between the two groups(P<0.05);(3)In the 115 patients with testicular germ cell tumors,there were 20 patients with lymph node metastasis and 95 patients without lymph node metastasis.In patients with lymph node metastases,there were 12 patients in the high NLR group,of which 1 died,and the survival rate was 91.7%.There were 8 patients in the low NLR group,of which 2 died,and the survival rate was 75%.The difference was significant.Differences(P<0.05);In patients without lymph node metastasis,there were 52 patients in the high NLR group,of which 8 died,and the survival rate was 84.6%.There were 43 patients in the low NLR group,no deaths,and the survival rate was 100.%,there was no significant difference(P>0.05);Conclusion:(1)There was no significant correlation between the preoperative NLR and postoperative overall survival of testicular germ cell tumor,but the preoperative NLR was negatively correlated with the patient’s postoperative overall survival in testicular non-seminomas.Patients with poor prognosis are often seen in patients with high preoperative NLR(NLR ≥ 2.56),and there is no significant difference in overall survival between patients with seminoma.(2)postoperative high NLR is often associated with higher tumor stage;(3)in the absence of lymph node metastasis NLR in patients with testicular germ tumors is more valuable in assessing patients’ prognosis,and preoperative high NLR patients tend to have poorer prognosis.