首页|术前外周血炎症相关指标对肾透明细胞癌Fuhrman分级预测价值的研究

术前外周血炎症相关指标对肾透明细胞癌Fuhrman分级预测价值的研究

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目的 探讨全身免疫炎症指数(SII)、全身炎症反应指数(SIRI)、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)、白蛋白与球蛋白比值(AGR)以及热休克蛋白90α(HSP90α)对肾透明细胞癌(ccRCC)Fuhrman分级的预测价值.方法 2019年10月~2022年8月因ccRCC行手术治疗的病人212例,根据Fuhrman分级情况,分为低级别肿瘤组和高级别肿瘤组.通过单因素和多因素Logistic回归分析确定Fuhrman分级的独立影响因素,绘制受试者工作特征曲线(ROC)评估各炎症指标对Fuhrman分级的预测价值,构建列线图预测模型,并评估预测模型的有效性.结果 术前SII、PLR、AGR、HSP90α水平和肿瘤最大径在高级别组与低级别组间比较,差异有统计学意义(P<0.05).Logistic回归分析显示,肿瘤最大径、PLR、AGR和HSP90α是Furhman分级的独立影响因素.绘制ROC曲线发现,术前PLR、AGR和HSP90α预测Furhman分级的曲线下面积(AUC)分别为0.641、0.675和0.696.此外,Furhman分级列线图预测模型具备较好的预测能力,AUC为0.789(95%CI:0.717-0.862),敏感度为61.80%,特异度为85.40%.结论 外周血炎症相关指标是ccRCC Furhman分级的影响因素,基于肿瘤最大径和外周血炎症指标构成的Furhman分级列线图预测模型具备较好的预测能力.
Study on the predictive value of preoperative peripheral blood inflammatory related indexes in Fuhrman grade of clear cell renal cell carcinoma
Objective To explore the predictive value of systemic immune inflammatory index(SII),systemic inflammatory response index(SIRI),neutrophil to lymphocyte ratio(NLR),lymphocyte to monocyte ratio(LMR),platelet to lymphocyte radio(PLR),albumin to globulin(AGR)and heat shock protein 90α(HSP90α)in Fuhrman grade of clear cell renal cell carcinoma(ccRCC).Methods From October 2019 to August 2022,212 patients who underwent surgical treatment for ccRCC were divided into low-grade tumor group and high-grade tumor group according to Fuhrman grade.The independent influencing factors of Fuhrman grading were determined by univariate and multivariate Logistic regression analysis,and the predictive value of each inflammatory index to Fuhrman grading was evaluated by drawing Receiver operating characteristic curve(ROC).We constructed the line chart prediction model and evaluated the effectiveness of the model.Results The preoperative levels of SII,PLR,AGR,HSP90α and the maximum diameter of tumor were significantly different between high-grade group and low-grade group(P<0.05).Logistic regression analysis showed that the maximum diameter of tumor,PLR,AGR and HSP90α were independent influencing factors of Furhman grade.By drawing the ROC curve,it was found that the area under the curve(AUC)of PLR,AGR and HSP90α to predict Furhman grade were 0.641,0.675 and 0.696.In addition,the Furhman grade line chart prediction model had good prediction ability,the AUC was 0.789(95%CI:0.717~0.862),the sensitivity was 61.80%,and the specificity was 85.40%.Conclusions There was a significant correlation between inflammation-related indexes in peripheral blood and Furhman grade of clear cell renal cell carcinoma.The Furhman grade line chart prediction model based on the maximum diameter of tumor and peripheral blood inflammation index has good predictive ability.

renal cell carcinomainflammatory indexesFurhman gradepredictive value

李浩、于莹莹、宋祥伟、张鹤骞、滕立臣

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150081 哈尔滨医科大学附属肿瘤医院泌尿外科

黑龙江省齐齐哈尔市第一医院

肾细胞癌 炎症指标 Furhman分级 预测价值

哈尔滨医科大学附属肿瘤医院海燕基金

JJMS 2022-14

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(5)
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