The Value Of Preoperative Neutrophil To Lymphocyte Ratio In Prognosis Of Testicular Germ Cell Tumor Patients

Objective: To investigate the value of neutrophil-lymphocyte ratio(NLR)on prognosis of patients with testicular germ cell tumors before surgery.Methods: The clinical data of 71 patients with testicular germ cell tumor who were admitted to our hospital from August 1,2012 to December 31,2017 and met the inclusion criteria were retrospectively analyzed.According to the postoperative pathology,the patients were divided into two groups,including 45 patients in the seminoma group and 26 patients in the non-seminoma group.The preoperative neutrophil-lymphocyte ratio(NLR)of 71 patients included in the clinical case data analysis was calculated to be 1.99,so 1.99 was selected as the critical value.Discussion:(1)the relationship between preoperative NLR size and postoperative cancer specific survival(CSS)of patients with testicular germ cell tumor;The relationship between the size of preoperative NLR and CSS was discussed in two subgroups,the seminoma group and the non-seminoma group,respectively.The correlation between preoperative NLR size and CSS was discussed in two subgroups with and without lymph node metastasis.(4)the relationship between the size of preoperative NLR and the patient’s pathological stage;The survival time of the study targets was compared by kaplan-meier method,and the difference between the two survival curves was determined by Log rank test.In this study,the correlation between NLR size and pathological staging was analyzed by the four-grid chi-square test.Results:(1)Of the 71 testicular germ cell tumor patients,the survival rates of the high NLR group(36 cases)and the low NLR group(35 cases)were 69.4%and 94.3%,respectively.Survival analysis showed that there was no statistically significant difference in postoperative survival curves between the high NLR group and the low NLR group(P>0.05).(2)Of the 45 patients with testicular seminoma,the survival rates of the high NLR group(24 cases)and the low NLR group(21 cases)were 91.7% and 90.5%,respectively.There was no statistically significant difference in postoperative survival curves between high NLR group and low NLR group in seminoma patients(P>0.05).Among the 26 patients with non-seminoma of the testis,the survival rates of the high NLR group(15 cases)and the low NLR group(11 cases)were 73.3% and 100%,respectively.There was a statistically significant difference in postoperative survival curves between the high NLR group and the low NLR group in non-seminoma patients(P<0.05).(3)Of the 13 patients with lymph node metastasis,the survival rates of the high NLR group(10 cases)and low NLR group(3 cases)were 60% and 66.7%,respectively.Among patients with lymph node metastasis,there was no statistically significant difference in postoperative survival curves between the high NLR group and the low NLR group(P>0.05);of the 58 patients with no lymph node metastasis,the high NLR group(26 cases)and low NLR The survival rates of the group(32 cases)were 92.3% and 96.9%,respectively.There was no statistically significant difference in postoperative survival curves between the high NLR group and the low NLR group in the non-lymph node metastasis group(P>0.05).(4)According to the preoperative imaging results and postoperative pathological results,71 patients with testicular germ cell tumors can be divided into two groups of stage Ⅰ and stage Ⅱ and above.At the same time,they are divided into NLR ≥ 1.99 and NLR <1.99 according to NLR.Group,to explore and analyze the relationship between NLR and tumor pathological stage,we get a total of 54 patients in stage I,including 23 patients in the high NLR group and 31 patients in the low NLR group;13 patients in the high NLR group at stage II and above Patients,4 patients in the low NLR group.By analyzing the four-square table chi-square test,we can conclude from this result that the difference in pathological stage between the high NLR group and the low NLR group is statistically significant(P<0.05).Conclusions: 1.In patients with testicular germ cell tumors,NLR did not find obvious evaluation value in evaluating the overall prognosis of patients,and patients in the seminoma group also did not find obvious evaluation value in prognosis;but in testicular non-seminoma Patients with a higher preoperative NLR(≥1.99)have a worse prognosis,and may become a simple and economic indicator for judging and evaluating the prognosis of testicular nonseminoma;2.Patients with a higher preoperative NLR are helpful for judgment And diagnosis of higher tumor stage.