术前外周血血小板计数及血小板与淋巴细胞的比值与肾细胞癌预后的关系

朱岩; 杨宪法; 牛远杰; 赵耀瑞

doi:10.13201/j.issn.1001-1420.2019.07.006

术前外周血血小板计数及血小板与淋巴细胞的比值与肾细胞癌预后的关系

- 1. 天津医科大学(天津, 300070);
- 2. 天津医科大学第二医院泌尿外科;
- 3. 中国人民武装警察部队特色医学中心泌尿外科

详细信息

通讯作者: 赵耀瑞,E-mail:zhaoyaorui@sina.com

中图分类号: R737.11

收稿日期: 2018-04-15

Prognostic value of preoperative platelet count and platelet-lymphocyte ratio in patients with renal cell carcinoma

- 1. Tianjin Medical University, Tianjin, 300070, China;
- 2. Department of Urology, Second Hospital of Tianjin Medical University;
- 3. Department of Urology, Characteristic Medicial Center of People's Armed Police Force

More Information

Corresponding author: ZHAO Yaorui, E-mail: zhaoyaorui@sina.com

Received Date: 15 April 2018

摘要

摘要: 目的：探讨术前外周血血小板（PLT）计数及血小板与淋巴细胞的比值（PLR）与肾细胞癌（RCC）预后的关系。方法：回顾性分析2006年1月~2013年12月1 340例经病理确诊的RCC患者的临床资料及随访资料。应用Kaplan-Meier法及Log-rank检验进行单因素分析，应用Cox比例风险回归模型对可能影响RCC预后的因素进行多因素分析，从而验证在众多影响RCC患者预后的因素中术前外周血PLT计数及PLR是否是RCC预后的独立影响因素。结果：术后获访并符合条件的患者1 125例，随访时间1~143个月，中位随访时间74个月。应用受试者工作特征曲线法确定PLR的最佳截点为146.86。术前外周血PLT计数升高组（>300×109/L）和非升高组（≤300×109/L）患者的1、3、5、7、10年总生存率（OS）分别为93.5%、71.2%、63.6%、51.4%、43.6%和98.1%、93.1%、88.9%、83.6%、80.1%，两组比较差异有统计学意义（χ²=100.39，P<0.001）。高PLR组（PLR≥146.86）和低PLR组（PLR<146.86）患者的1、3、5、7、10年OS分别为95.5%、83.8%、74.9%、65.0%、57.4%和98.6%、93.7%、91.3%、87.1%、84.9%，两组比较差异有统计学意义（χ²=79.21，P<0.001）。Cox多因素分析结果显示，年龄、肿瘤大小、术时远处转移、术前外周血PLT计数、PLR、pT分期（2010）、Fuhrman分级、ECOG评分是影响RCC预后的独立影响因素（P<0.05）。结论：术前外周血PLT计数升高及高PLR均是RCC患者预后不良的独立影响因素。
- 肾细胞癌 /
- 血小板 /
- 血小板与淋巴细胞比值 /
- 预后 /
- 生存率
Abstract: Objective: To explore the prognostic value of preoperative platelet count and platelet-lymphocyte ratio (PLR) in patients with renal cell carcinoma.Method: A retrospective study was conducted in 1 340 patients with renal cell carcinoma who underwent nephrectomy or partial nephrectomy between January of 2006 and December of 2013.The survival was calculated by Kaplan-Meier analysis.The difference between groups was compared using Log-rank test.Cox regression was used to analyze the factors which may affect the survival of the patients, so as to verify whether preoperative platelet count and PLR were independent predictors of renal cell carcinoma.Result: By the end of the study, 1 125 cases who met the inclusion criteria were followed up.The median follow-up period was 74 (range, 1-143) months.The point of PLR was calculated by receiver operating characteristic curves, and the optimal cut-off point was 146.86.The estimated 1-, 3-, 5-, 7-, 10-year overall survival rates for preoperative platelet count>300×109/L group and preoperative platelet count ≤ 300×109/L group were 93.5%, 71.2%, 63.6%, 51.4%, 43.6% and 98.1%, 93.1%, 88.9%, 83.6%, 80.1%, respectively.The difference was significant (χ²=100.39, P<0.001).The estimated 1-, 3-, 5-, 7-, 10-year overall survival rates for PLR ≥ 146.86 group and PLR <146.86 group were 95.5%, 83.8%, 74.9%, 65.0%, 57.4% and 98.6%, 93.7%, 91.3%, 87.1%, 84.9%, respectively.The difference was significant (χ²=79.21, P<0.001).Multivariate analysis showed that age, tumor size, distal metastasis at the time of surgery, preoperative platelet count, PLR, tumor stage (2010), Fuhrman grade and ECOG score were independent risk factors affecting overall survival in renal cell carcinoma patients.Conclusion: Preoperative platelet count>300×109/L and PLR ≥ 146.86 are independent poor predictors of renal cell carcinoma.
- renal cell carcinoma /
- platelet /
- platelet-lymphocyte ratio /
- prognosis /
- survival rate

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