系统性炎症反应对二线分子靶向治疗转移性肾癌患者生存率的影响

Effect of systemic inflammation on survival in patients with metastatic renal cell carcinoma receiving second-line molecular-targeted therapy

目的:探讨系统性炎症反应对二线分子靶向治疗转移性肾癌患者生存率的影响。方法:本次研究共纳入2007年1月至2016年8月我院收治的63例使用一线TKI治疗失败后接受二线m TT的mRCC患者作为研究对象。根据炎症标志物水平对使用二线m TT治疗患者的PFS和OS进行评估。此外,我们对生存的预后因素进行了分析。结果:CRP、NLR和PLR的受试者工作特征曲线(ROC)的曲线下面积(AUC)分别为0.779、0.619和0.655,无显著差异。相应的截止值分别为0.48、2.53和183。CRP(n=40)、NLR(n=31)与PLR(n=22)水平较高患者的PFS和OS均显著低于较低CRP、NLR和PLR水平的患者。多因素分析显示,CRP是PFS和OS唯一的独立预测因子。结论:系统性炎症反应与使用二线m TT的mRCC患者的生存率密切相关,CRP可以作为此类患者预后的独立预测因子。

Objective： To explore the effect of systemic inflammation on survival in patients with metastatic renal cell carcinoma receiving second-line molecular-targeted therapy. Methods： A total of 63 cases of patients with metastatic renal cell carcinoma receiving second-line m TT after first-line tyrosine kinase inhibitor failure in our hospital from January 2007 to August 2016 were recruited. PFS and OS after second-line m TT initiation were evaluated according to the inflammatory marker levels. In addition,the prognostic factors for survival were examined. Results：The receiver operating characteristic curves（ ROC） for CRP,NLR and PLR had areas under the curve（ AUC） of 0. 779,0. 619 and 0. 655,respectively. No significant differences were noted. The corresponding cutoff values were0. 48,2. 53 and 183. Patients with higher CRP（ 40 cases）,NLR（ 32 cases） and PLR（ 22 cases） levels had significantly lower PFS and OS than those with lower CRP,NLR and PLR levels. Multivariate analyses showed that CRP was the sole independent predictor for PFS and OS. Conclusion： Systemic inflammation is associated with survival after second-line m TT. In particular,CRP was a strong independent predictive biomarker of prognosis.