Correlation Between Neutrophil-to-lymphocyte Ratio And Platelet-to-lymphocyte Ratio To The Prognosis Of Renal Cell Carcinoma Before Surgery

Background At present,The accurate staging of the tumor and the presence of distant metastasis are the basis of the prognosis of cancer.However,there is a growing recognition that the patient’s own factors are associated with poor cancer prognosis,and the presence of systemic inflammatory responses is a major factor in the decline of the patient’s condition.Peripheral blood neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are objective indicators of systemic inflammatory response.Recently,more and more recent studies have shown that NLR and PLR are associated with the prognosis of solid tumors such as gastric cancer,and it is not clear whether it is associated with the prognosis of renal cell carcinoma.Objective To investigate whether NLR and PLR are related to the prognosis of renal cell carcinoma as indicators of systemic inflammatory response,and whether NLR and PLR are independent risk factors for poor prognosis of renal cell carcinoma.Methods The clinical data and postoperative follow-up data of patients with renal cell carcinoma who were treated in The First Affiliated Hospital of Xinxiang Medical College and the Third Affiliated Hospital of Xinxiang Medical College from January 2008 to January 2013 were retrospectively analyzed.The optimal cut-off values of NLR and PLR were determined using the receiver working curve;The chi-square test was used to analyze the clinical features;Survival rate was calculated by Kaplan-Meier method.Log-rank test was used to compare the survival rate.The independent factors of renal cell carcinoma prognosis was assessed using Cox multivariate regression.Results A total of 236 renal cell carcinoma patients meeting the requirements of th is experiment were collected.The optimal cutoff values of NLR and PLR determi ned by the receiver operating characteristic curve(ROC curve)were 1.25 and 186.37,respectively.According to the critical value,the patients were divided into hig h and low NLR groups and high and low PLR groups.The chi-square test showed that There was no statistical difference in age(χ2=0.619,P=0.431),gender(χ2=2.022,P=0.155),diabetes history(χ2=0.254,P=0.614),hypertension history(χ2=0.084,P=0.772),tumor size(χ2=1.378,P=0.240)between the high NLR group and th e low NLR group,The same result can be obtained by comparing the high PLR g roup with the low PLR group.but The TNM stage(χ2=6.954,P=0.008)and pathol ogical grade(χ2=3.883,P=0.049)of high NLR group were higher than those of l ow NLR group,and more patients were metastasized(χ2=6.731,P=0.009).The TN M stage(χ2=11.291,P=0.001)and pathological grade(χ2=4.506,P=0.034)of high PLR group were higher than those of low PLR group,and more patients were metastasized(χ2=11.638,P=0.001).Log-rank test results showed that the 5-year su rvival rate of high NLR group was lower than low NLR group(Log-rank=38.95,P<0.001),and the 5-year survival rate of high PLR group was lower than that of low PLR group(Log-rank=38.95,P<0.001);Cox multivariate regression analysis sh owed that high NLR and high PLR were independent risk factors for poor progn osis of renal cell carcinoma,At the same time,TNM≥III,pathological grade≥3 an d metastasis were significantly associated with the prognosis of renal cell carcino ma.Conclusions1.There was a negative correlation between the level of NLR and PLR and the prognosis of renal cell carcinoma.2.High NLR and high PLR were independent risk factors for poor prognosis in renal cell carcinoma.3.TNM≥III,pathological grade≥3 and metastasis were significantly associated with the prognosis of renal cell carcinoma.