血清组织多肽特异性抗原、中性粒细胞与淋巴细胞比值、白蛋白与球蛋白比值联合检测在乳头状肾细胞癌预后评估中的临床价值

Clinical value of combined detection of serum tissue polypeptide-specific antigen,neutrophil-to-lymphocyte ratio and albumin-globulin ratio in prognostic assessment of papillary renal cell carcinoma

目的评估血清组织多肽特异性抗原(TPS)、中性粒细胞与淋巴细胞比值(NLR)、白蛋白与球蛋白比值(AGR)联合检测对乳头状肾细胞癌预后预测的效果。方法回顾性分析2021年2月至2022年10月期间在周口市中医院接受治疗并完成18个月随访的130例乳头状肾细胞癌患者,将其作为观察组,同时选取同期130例健康体检者作为对照组。比较2组血清TPS、NLR、AGR水平,并分析观察组患者不同生存状态下这些指标的变化。结果观察组血清TPS、NLR均高于对照组,而AGR低于对照组(t=17.929,P<0.001;t=13.431,P<0.001;t=15.773,P<0.001)。死亡患者血清TPS、NLR均高于生存患者,而AGR低于生存患者(t=5.310,P<0.001;t=7.090,P<0.001;t=3.845,P<0.001)。血清TPS、NLR升高和AGR降低为乳头状肾细胞癌患者术后生存状态的独立影响因素(P=0.019;P<0.001;P<0.001)。TPS、NLR、AGR、3项联合预测乳头状肾细胞癌患者预后的曲线下面积分别为0.715、0.832、0.682、0.941。结论TPS、NLR、AGR联合检测对乳头状肾细胞癌患者的预后预测效能高,且患者高TPS、NLR与低AGR为患者预后的不利因素。

Objective To evaluate the efficacy of combined detection of serum tissue polypeptide-specific antigen(TPS),neutrophil-to-lymphocyte ratio(NLR)and albumin-globulin ratio(AGR)in predicting the prognosis of papillary renal cell carcinoma.Methods We retrospectively analyzed 130 patients with papillary renal cell carcinoma who were treated and followed up for 18 months from February 2021 to October 2022 at our hospital,serving as the observation group,and also selected 130 healthy individuals from the same period as the control group.The levels of serum TPS,NLR,and AGR were compared between the two groups,and the changes in these indicators under different survival states of the observation group were analyzed.Results The serum levels of TPS and NLR in the observation group were higher than those in the control group,while the AGR was lower than that in the control group(t=17.929,P<0.001;t=13.431,P<0.001;t=15.773,P<0.001).The serum levels of TPS and NLR of the deceased patients were higher than those of surviving patients,while the AGR was lower than that in the control group(t=5.310,P<0.001;t=7.090,P<0.001;t=3.845,P<0.001).The high TPS and NLR,and low AGR were the independent influencing factors for the patients.The prognostic efficacy analysis showed that the area under the curve for TPS,NLR and AGR,as well as their combined prediction of papillary renal cell carcinoma patient prognosis,were 0.715,0.832,0.682 and 0.941,respectively.Conclusion The combined detection of TPS,NLR,and AGR has high prognostic efficacy for patients with papillary renal cell carcinoma,and high levels of TPS and NLR,along with low AGR,are unfavorable factors for patient prognosis.