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Multicenter Study
. 2018 Jun 11;18(1):60.
doi: 10.1186/s12894-018-0374-z.

Preoperative neutrophil-to-lymphocyte ratio predicts the surgical outcome of Xp11.2 translocation/TFE3 renal cell carcinoma patients

Sezim Agizamhan  1 , Feng Qu  1 , Ning Liu  1 , Jing Sun  2 , Wei Xu  3 , Lihua Zhang  4 , Hongqian Guo  1 , Weidong Gan  5
Affiliations
Multicenter Study

Preoperative neutrophil-to-lymphocyte ratio predicts the surgical outcome of Xp11.2 translocation/TFE3 renal cell carcinoma patients

Sezim Agizamhan et al. BMC Urol. .

Abstract

Background: The preoperative neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CRP/Alb ratio) and platelet-to-lymphocyte ratio (PLR) have been demonstrated to predict the clinical outcome of various human cancer, including renal cell carcinoma(RCC). The aim of our study was to explore the prognostic values of these ratios in patients with Xp11.2 translocation/TFE3 gene fusions renal cell carcinoma (Xp11.2 tRCC).

Methods: A retrospective multicentre study was performed in 82 Xp11.2 tRCC patients who underwent radical or partial nephrectomy. The optimal cutoff values of the NLR, CRP/Alb ratio and PLR were determined by the receiver operating characteristic (ROC) analysis. The impact of the NLR, CRP/Alb ratio and PLR, as well as other clinicopathological characteristics, on disease-free survival (DFS) and overall survival (OS) were evaluated using the univariate and multivariate Cox regression analyses.

Results: The optimal cutoff values of the NLR, CRP/Alb ratio and PLR were set at 2.45, 140 and 0.08, respectively, according to the ROC analysis. Univariate analyses showed that the NLR, CRP/Alb ratio and PLR all were associated with DFS of Xp11.2 tRCC patients (P < 0.001, P = 0.005 and P = 0.001, respectively) and OS of Xp11.2 tRCC patients (P = 0.016, P = 0.003 and P = 0.014, respectively). Multivariate analysis indicated that the NLR was independently associated with DFS of Xp11.2 tRCC patients (hazard ratio [HR]: 4.25; 95% confidence interval [95% CI]: 1.19-15.18; P = 0.026) along with age (P = 0.004), the pT status (P < 0.001) and the pN status (P < 0.019), and the NLR (HR: 26.26; 95% CI: 1.44-480.3; P = 0.028) also was independently associated with OS in patients with Xp11.2 tRCC, along with age (P = 0.016) and a tumour thrombus (P = 0.007).

Conclusion: Overall, relatively high NLRs, CRP/Alb ratios and PLRs were associated with a poor prognosis of Xp11.2 tRCC patients; among of them, only the NLR independently predicted the progression of Xp11.2 tRCC, and the NLR may help to identify patients with high metastasis or relapse risk.

Keywords: C-reactive protein/albumin ratio; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; Renal cell carcinoma; Xp11.2 translocation.

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Conflict of interest statement

Ethics approval and consent to participate

The study received the ethics approval from the Ethics Committee of Nanjing Drum Tower Hospital, Jiangsu Province Hospital, Jiangsu Cancer Hospital and Zhongda Hospital Southeast University.

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.

All patients agreed and signed the informed consent to participate in the study, and they agreed that their information (including clinical information, surgical related data, pathological data, blood laboratory tests and surveillance) would be collected for scientific study and published in professional medical journals.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The predictive abilities of the preoperative NLR, CRP/Alb ratio and PLR were compared using ROC curves
Fig. 2
Fig. 2
Kaplan–Meier curves for independent predictors in multivariate analysis regarding DFS (n = 78) and OS (n = 82). a: OS stratified by the NLR; b: DFS stratified by the NLR; c: DFS stratified by pT status; d: DFS stratified by pN status; e: OS stratified by age; f: DFS stratified by age; g: OS stratified by tumour thrombus
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