NLR-PLT评分在舒尼替尼治疗转移性肾癌患者中的应用

Prediction value of NLR-PLT in patients of metastatic renal cell carcinoma treated with sunitinib

目的：探究中性粒细胞与淋巴细胞比值联合血小板（NLR-PLT）评分系统在舒尼替尼治疗的转移性肾细胞癌患者中的预测价值。方法：回顾性分析2008年3月~2014年2月在复旦大学附属肿瘤医院接受舒尼替尼治疗的161例转移性肾癌患者的临床资料,并进行NLR-PLT评分,分析炎症指标和总生存时间的相关性。用一致性指数（C-index）评价预测效能。结果：Kaplan-Meier生存曲线分析结果示NLR-PLT评分与总生存时间相关（P〈0.01）。经年龄、性别和MSKCC危险度分层校正后的多因素Cox回归分析显示NLR-PLT评分1分（HR=2.64,95%CI=1.17~2.97,P=0.008）和2分（HR=2.91,95%CI=1.40~5.67,P=0.004）是生存预后的独立预测因子。该多因素模型的一致性指数为0.699。结论：炎症指标NLR-PLT评分能准确地判断舒尼替尼靶向治疗效果。

Objective：To investigate the prediction value of combination of neutrophil-to-lymphocyte ratio and platelet（NLR-PLT）in patients of metastatic renal cell carcinoma（RCC）treated with sunitinib.Method：Totally161patients of metastatic RCC treated with sunitinib in Fudan University Shanghai Cancer Center from 2008to2014 were retrospectively analyzed.NLR-PLT was calculated as the marker of systemic inflammation.Analyses were performed to test the association between the inflammation marker and overall survival.Harrell concordance index（C-index）was used to test the performance of the model.Result：Kaplan-Meier analysis showed NLR-PLT（P〈0.01）was associated with overall survival.After adjusted for age,sex and MSKCC score,multivariate Cox analysis indicated NLR-PLT=1（HR=2.64,95%CI=1.17-2.97,P =0.008）and 2（HR=2.91,95%CI=1.40-5.67,P =0.004）were independent prognostic predictors.The C-index of NLR-PLT model was 0.699.Conclusion：The NLR-PLT is considered as an accurate predictor of overall survival in patients of metastatic RCC treated with sunitinib.