首页|控制营养状态评分和相关炎性指标在肾透明细胞癌预后预测中的价值:一项多中心回顾性研究

控制营养状态评分和相关炎性指标在肾透明细胞癌预后预测中的价值:一项多中心回顾性研究

Value of controlling nutritional status score and related inflammatory indicators in predicting the prognosis of patients with clear cell renal cell carcinoma:a multi-center retrospective study

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  • 维普
  • 万方数据
目的 探讨控制营养状态(CONUT)评分和相关炎性指标在肾透明细胞癌(ccRCC)患者预后预测中的价值,为临床更好地评估病情及制定个体化治疗方案提供参考.方法 回顾性分析2010-2018年宜宾市4所综合性医院收治的132例ccRCC患者的病历资料和生存情况,采用受试者工作特征曲线(ROC)分析CONUT评分及炎性指标中性粒细胞和淋巴细胞比值(NLR)、血小板和淋巴细胞比值(PLR)以及淋巴细胞和单核细胞比值(LMR)预测患者预后的曲线下面积和最佳截断值,Kaplan-Meier法绘制生存曲线,采用Log-rank检验和Cox回归分析影响预后的因素.结果 患者中位随访时间62(53,71)个月,随访期内死亡37例(28.03％),疾病特异性生存期(DSS)和无进展生存时间(PFS)分别为51(41,58)个月和46(35,56)个月,患者3、5年DSS分别为84.09％和71.97％,3、5年PFS分别为75.00％和71.97％.CONUT评分、NLR、PLR以及LMR预测患者预后的ROC曲线下面积(AUC)分别为0.980、0.905、0.899和0.884,最佳截断值分别为3.50分、3.19、89.07和3.56.多因素Cox回归分析显示:CONUT 评分和 PLR 与患者 DSS 有关,其 HR(95％CI)分别为 0.042(0.013～0.140)和 0.182(0.045～0.744);CONUT 评分和LMR与患者PFS有关,其HR(95％CI)分别为0.029(0.010～0.086)和2.984(1.227～7.258).结论 ccRCC患者预后与机体营养、免疫和炎症状况有关,CONUT评分和炎症相关指标(PLR、LMR)可能是患者DSS和PFS的重要预测因子.
Objective To explore the value of controlling nutritional status(CONUT)score and related inflammatory indicators in predicting the prognosis of clear cell renal cell carcinoma(ccRCC)patients,to provide a reference for better clinical assessment and individualized treatment plan.Methods A retrospective study was conducted on 132 patients with ccRCC admitted to four comprehensive hospitals in Yibin during 2010 and 2018.Patients'medical and follow-up records were collected,and receiver operating characteristic(ROC)curve was drawn to analyze the area under the curve(AUC)and optimal cut-off value of CONUT score and related indicators.Survival curve was plotted with Kaplan-Meier method,and the influencing factors of prognosis were analyzed with Log-rank test and Cox regression.Results During the follow-up of 62(53,71)months,37(28.03％)deaths occurred.The disease-specific survival(DSS)and progression-free survival(PFS)were 51(41,58)and 46(35,56)months,respectively.The 3-year and 5-year DSS and PFS were 84.09％and 71.97％,and 75.00％and 71.97％,respectively.The AUC of CONUT score,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and lymphocyte to monocyte ratio(LMR)were 0.980,0.905,0.899 and 0.884,respectively,with the optimal cut-off values of 3.50,3.19,89.07 and 3.56,respectively.Cox regression showed that CONUT score(HR=0.042,95％CI:0.013-0.140)and PLR(HR=0.182,95％CI:0.045-0.744)were associated with DSS;CONUT score(HR=0.029,95％CI:0.010-0.086)and LMR(HR=2.984,95％CI:1.227-7.258)were associated with PFS.Conclusion The prognosis of ccRCC patients is related to their nutritional,immune,and inflammatory status.CONUT score and inflammatory factors(PLR,LMR)may be important predictors of DSS and PFS.

clear cell renal cell carcinomacontrolling nutritional status scoreprognosisplatelet to lymphocyte ratiolymphocyte to monocyte ratio

谢芳、冯传宗、张成、沈雪娇、周建

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宜宾市第三人民医院护理部,四川宜宾 644000

宜宾市第六人民医院泌尿外科,四川宜宾 644600

宜宾市第一人民医院泌尿外科,四川宜宾 644000

宜宾市第二人民医院泌尿外科,四川宜宾 644000

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肾透明细胞癌 控制营养状态评分 预后 血小板和淋巴细胞比值 淋巴细胞和单核细胞比值

四川省卫生健康委项目

21PJ133

2024

10.3969/j.issn.1009-8291.2024.05.005

现代泌尿外科杂志
西安交通大学

现代泌尿外科杂志

CSTPCD
影响因子：1.106
ISSN：1009-8291
年,卷(期)：2024.29(5)
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