纤维蛋白原联合检测中性粒细胞与淋巴细胞比值与肾癌临床病理及预后的相关性研究

Correlation study between combined detection of fibrinogen and Neutrophil-lymphocyte ratio and clinicopathology and prognosis of renal cell carcinoma

目的探讨纤维蛋白原(fibrinogen,FIB)与中性粒细胞与淋巴细胞比值(Neutrophil-lymphocyte ratio,NLR)联合形成的指标FIB-NLR与肾细胞癌(renal cell carcinoma,RCC)临床病理因素及预后的相关性。方法回顾性分析2016-09—2019-08间郑州大学第一附属医院泌尿外科收治的184例病理确诊为RCC患者的临床资料。以ROC(receiver operating characteristic,ROC)曲线的NLR与FIB区分组织分级的最佳截断值对患者进行分组。比较不同FIB-NLR组间的临床病理特征间的差异。通过Kaplan-Meier法进行生存分析,绘制生存曲线,并采用Log-rank法比较各组生存曲线的差异。建立单因素及多因素Cox比例风险模型,探讨影响预后的危险因素。结果根据ROC曲线最佳截点分组为FIB-NLR 0分组:FIB≤4.1 g/L且NLR≤2.75。FIB-NLR 1分组:FIB>4.1 g/L或NLR>2.75。FIB-NLR 2分组:FIB>4.1g/L且NLR>2.75。不同FIB-NLR组间肿瘤直径、T分期、组织分级上差异有统计学意义(P<0.05)。多因素分析显示FIB、NLR及FIB-NLR是影响患者无进展生存率(Disease-free survival,DFS),肿瘤特异性生存率(cancer specific survival,CSS)的独立危险因素。FIB-NLR 2分组患者DFS及CSS明显低于FIB-NLR 0分及1分组患者,差异有统计学意义(P<0.05)。结论FIB-NLR与RCC的病理特征密切相关,且可作为预测肾癌患者预后和决定治疗策略的指标。

Objective To explore the correlation between combined detection of fibrinogen and Neutrophil-lymphocyte ratio(FIB-NLR)and clinical pathological factors and prognosis of renal cell carcinoma(RCC).Methods The clinical data of 184 patients with pathologically confirmed RCC were retrospectively analyzed from September 2016 to August 2019.The patients were divided into groups according to the cut-off value of ROC curve NLR and FIB to distinguish tissue grade.The difference of clinicopathological characteristics were compared among FIB-NLR groups.Survival analysis was performed by Kaplan-Meier method,survival curves were plotted,and log-rank methods were used to compare the differences in survival curves between groups.Single factor and multi factor Cox proportional risk model were established to explore the risk factors of prognosis.Results According to the optimal cut-off points of the ROC curve,the grouping results were FIB-NLR 0 group:FIB≤4.1 g/l and NLR≤2.75;FIB-NLR 1 group:FIB>4.1 g/l or NLR>2.75,FIB-NLR 2 group:FIB>4.1 g/l and NLR>2.75.There were statistically significant differences in tumor diameter,T stage and tissue grade among FIB-NLR groups(P<0.05).In addition,multiple factor analysis showed that FIB,NLR and FIB-NLR were independent risk factors for Disease-free survival(DFS)and cancer specific survival(CSS).The DFS and CSS of patients in the FIB-NLR 2 group were significantly lower than those of the FIB-NLR 0 and 1 groups(P<0.001).Conclusion s FIB-NLR is closely related to the pathological features of RCC,which can be used as an indicator to predict the prognosis of renal cancer patients and determine treatment strategies.