C反应蛋白和中性粒细胞/淋巴细胞比值在肾透明细胞癌患者舒尼替尼治疗效果和预后评估中的价值

Value of C-reactive protein and neutrophil/lymphocyte ratio in evaluating the therapeutic effect and prognosis of sunitinib in treating patients with clear cell renal cell carcinoma

目的探讨C反应蛋白(CRP)和中性粒细胞/淋巴细胞比值(NLR)在肾透明细胞癌(cc RCC)患者舒尼替尼治疗效果和预后评估中的价值。方法选取50例cc RCC患者进行研究,所有患者均进行舒尼替尼治疗,主要终点为根据实体瘤疗效评价标准(RECIST)1.1版评估的客观缓解率(ORR)和临床获益率(CBR),次要终点是无进展生存期(PFS)和总生存期(OS),记录患者的不良反应。结果在41例可评估疗效的患者中,1例患者完全缓解(CR),8例患者部分缓解(PR),19例患者疾病稳定(SD),13例患者疾病进展(PD)。CRP水平≤10 mg/L、6周NLR≤3的cc RCC患者的ORR均高于CRP水平﹥10 mg/L、6周NLR﹥3的患者,6周NLR≤3的cc RCC患者的CBR高于6周NLR﹥3的患者,差异均有统计学意义(P﹤0.05)。CRP水平≤10 mg/L、6周NLR≤3、6周内NLR从﹥3到≤3可能与cc RCC患者较长的PFS和OS有关(P﹤0.05)。结论基线CRP可能是预测cc RCC治疗疗效的生物标志物,基线NLR与治疗疗效或生存期无显著相关性。

Objective To explore the value of C-reactive protein(CRP)and neutrophil/lymphocyte ratio(NLR)in evaluating the therapeutic effect and prognosis of sunitinib in treating patients with clear cell renal cell carcinoma(cc RCC).Method A total of 50 patients with cc RCC were enrolled and selected for the study.All patients received sunitinib treatment.The primary outcomes were the objective response rate(ORR)and clinical benefit rate(CBR)assessed by the response evaluation criteria in solid tumor(RECIST)version 1.1.The secondary outcomes were progression-free survival(PFS)and overall survival(OS).The patients’adverse events were also recorded.Result Among 41 patients with evaluable efficacy,one patient achieved complete response(CR),eight patients had partial response(PR),19 patients obtained stable disease(SD),and 13 patients had disease progression(PD).The ORR of cc RCC patients with CRP level≤10 mg/L and 6-week NLR≤3 was higher than that of patients with CRP level>10 mg/L and 6-week NLR>3,the CBR of cc RCC patients with 6-week NLR≤3 was higher than that of patients with 6-week NLR>3,and the differences were statistically significant(P<0.05).CRP≤10 mg/L,6-week NLR≤3,and NLR from>3 to≤3 within 6 weeks may be related to longer PFS and OS in cc RCC patients(P<0.05).Conclusion Baseline CRP may be a biomarker for predicting the efficacy of cc RCC treatment.There is no significant correlation between baseline NLR and treatment effect or survival.