中性粒细胞/淋巴细胞比值与上尿路尿路上皮癌的相关性分析

Correlation between neutrophil/lymphocyte ratio and upper tract urothelial carcinoma

目的分析术前中性粒细胞/淋巴细胞比值(NLR),寻找其与上尿路尿路上皮癌(UTUC)临床分级、分期及预后的关系,探讨其临床意义。方法选取2008年1月至2017年12月大连医科大学附属第二医院泌尿外科收治的70例UTUC患者,并分析其相关资料,男性47例,女性23例,年龄范围为35~85岁,中位年龄69岁。计算血中NLR,分析NLR与临床指标的关系,分析患者无病生存期(DFS)和总生存期(OS)的相关因素。结果70例患者中NLR 25%、50%及75%值分别为:1.7508、2.6299、4.7669。NLR表达高低、肿瘤大小、临床分期、病理分级、脉管癌栓与DFS相关,差异均有统计学意义(均P<0.05),Cox回归多因素分析显示NLR高低与患者DFS的预后因素相关(P<0.05)。NLR、临床分期、病理分级、是否局部复发、是否转移与患者OS相关性明显(均P<0.05)。多因素分析显示:NLR、高级别伴鳞化或腺化分级、是否局部复发及是否发生远处转移与OS预后因素相关(均P<0.05)。结论NLR高低与患者DFS的预后因素相关;NLR、高级别伴鳞化或腺化分级、是否局部复发及是否发生远处转移与OS呈现明显相关性,可能成为预测UTUC患者的病情评估及预后生存的指标。

Objective To find the relationship of ratio of neutrophils to lymphocytes(NLR)with the clinical classification,staging,and prognosis of upper urothelial carcinoma(UTUC)and to explore its clinical significance by analyzing preoperative NLR.Methods Seventy patients with UTUC treated in Department of Urology,Second Hospital Affiliated to Dalian Medical University were selected,including 47 males and 23 females.They were 35-85 years old,with a median of 69.Their related data were analyzed.The blood NLR was calculated.The relationship between the NLR and the clinical indicators was analyzed.The relevant factors of disease-free survival(DFS)and total survival(OS)were analyzed.Results The 25%,50%,and 75%NLR's were 1.7508,2.6299,and 4.7669 in the 70 patients.The NLR,tumor size,clinical stage,pathological grade,and vascular cancer embolus were correlated with DFS(all P<0.05).Multivariate analysis by Cox regression showed that the NLR was correlated with the prognostic factors of DFS(P<0.05).The NLR,clinical stage,pathological grade,local recurrence,and metastasis were significantly correlated with their OS(all P<0.05).Multivariate analysis showed that NLR,high grade with phosphating or adenylation,local recurrence,and distant metastasis were associated with OS prognostic factors(all P<0.05).Conclusions NLR is associated with prognostic factors of DFS.NLR,high grade with phosphating or adenylation,local recurrence,and distant metastasis are significantly correlated with OS and may be used as predictors of disease assessment and prognostic survival in UTUC patients.