The Prognostic Value Of The Preoperative Neutrophil-to-lymphocyte Ratio In Renal Cell Carcinoma

Objectives:In most malignant tumors,the increase of the ratio of Neutrophil-to-lymphocytes often indicates poor prognosis,but the ratio of Neutrophil-to-lymphocyte(NLR)in non-metastatic renal cell carcinoma(non-mRCC)is less discussed and controversial.In this study,we retrospectively analyzed 255 patients with non-metastatic renal cell carcinoma in our hospital to explore the prognostic value of Neutrophil-to-lymphocyte ratio in renal cell carcinoma.Materials and methods: 255 non-mRCC patients undergoing surgery were enrolled from the First Hospital of Jilin University between June 2008 to June 2012.The clinical data and the complete pathological data were collected.All the patients were followed up by making a call or the records of examination to assess the postoperative condition.A total of 255 complete case data were obtained.The neutrophil count and lymphocyte count were obtained from peripheral blood data,and the ratio of neutrophil-to-lymphocyte was calculated.The optimal NLR was obtained by using the Receiver operating characteristic curve.According to NLR,the case data were divided into high NLR group and low NLR group.The chi-square test was used to compare the clinical data between the two groups.SPSS24.0 statistical software was used to analyze.Univariate analysis and multivariate analysis were used to compare OS and RFS rate by Log-rank test and Cox risk regression,respectively,and Kaplan-Meier survival method was used to draw survival curve of renal cell carcinoma patients.Result:2.11 is the best NLR value for ROC.The comparison of clinicopathological factors between high and low NLR renal cell carcinoma patients showed that there were different in T stage,Fuhrman grade and clinical symptoms.The survival curve of RCC patients was drawn by Kaplan-Meier survival method,and the prognostic factors of RCC were analyzed by Log-rank test.Clinical symptom and T stage,Fuhrman grade,NLR and age significantly correlated with RFS and OS on univariate.Single factor method showed that RFS and OS had no statistical difference in gender,hypertension,diabetes and BMI.Multivariate analysis of prognostic factors in renal cell carcinoma with COX multivariate regression model show that RFS and OS significant difference in age and T stage,Fuhrman grade,clinical symptoms and NLR.Conclusion: 1.Due to the development of imaging examination and the improvement of people's health awareness,asymptomatic renal cell carcinoma is found in a high proportion.2.The NLR ratio greater than 2.11 is significantly worse than that of the less than 2.11 group.3.Peripheral blood NLR is correlated with Clinical symptom,T staging and Fuhrman grade.4.Peripheral blood NLR,T staging and age,Clinical symptom and Fuhrman grade are independent prognostic factors for overall survival of renal cell carcinoma.5.Peripheral blood NLR,T staging and age,Clinical symptom and Fuhrman grade are independent prognostic factors for Recurrence-Free survival of renal cell carcinoma.6.A personalized follow-up plan should be made for patients with high preoperative NLR.