2026-09-24T14:12:49Zhttps://repository.ajou.ac.kr/oai/request

oai:repository.ajou.ac.kr:201003/118712024-10-11T02:21:24Zcom_201003_14369com_201003_14368col_201003_14370

Prognostic significance of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with non-metastatic clear cell renal cell carcinoma 비전이 투명 신세포암 환자의 수술 전 호중구/림프구 비율과 혈소판/림프구 비율의 예후적 중요도 이, 정환 김, 선일 대학원 의학과 201224382 이, 정환 Renal cell carcinoma systemic inflammation prognosis 신장암 염증 예후 인자 Introduction & Objectives: This study was performed to evaluate the significance of preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as a predictive factor for recurrence in patients with non-metastatic clear cell renal cell carcinoma (RCC). Material & Methods: We retrospectively reviewed the medical records of 341 patients (232 men and 109 women, mean age of 54.9 years) with non-metastatic clear cell RCC who underwent radical or partial nephrectomy between March 1995 and July 2012. Patients longer than 12 months follow-up were included. The prognostic significance of various clinicopathological variables for recurrence-free survival and cancer specific-free survival was analyzed by using univariate and multivariate analysis. Results: The median follow-up duration was 48 months (mean, 54.1; range, 12-215 months). Of the total 341 patients, 37 patients (10.9%) developed metastases and 14 patients (4.1%) died of renal cell carcinoma among 21 patients who died during the follow-up period. Preoperative NLR was significantly correlated with symptom presentation (p=0.008), tumor size (p=0.022), T stage (p=0.004), neutrophil count (p<0.001), lymphocyte count (p<0.001), recurrence at follow-up (p=0.006). Preoperative PLR was significantly correlated with symptom presentation (p<0.001), lymphocyte count (p<0.001), recurrence at follow-up (p=0.002). In the univariate analysis, clinical presentation, tumor size, T stage, Fuhrman grade, preoperative hemoglobin, neutrophil count, NLR, PLR were significant prognostic factors for recurrence-free survival. The 5-year recurrence-free survival rate of patients with a higher preoperative NLR (≥2.5) was significantly lower than that of patients with a lower preoperative NLR (<2.5) (86.5% vs. 96.7%, p=0.006). The 5-year recurrence-free survival rate of patients with a higher preoperative PLR (≥130) was significantly lower than that of patients with a lower preoperative PLR (<130) (89.4% vs. 96.8%, p=0.022). In the multivariate analysis, tumor size (p<0.001), T stage (p<0.001), Fuhrman grade (p=0.015) and preoperative hemoglobin (p=0.026) were independent prognostic factors for recurrence-free survival. Conclusions: An increased preoperative NLR and PLR were associated with a higher recurrence rate in patients with non-metastatic clear cell RCC, although it was not an independent prognostic factor for recurrence-free survival. Ⅰ. INTRODUCTION 1 Ⅱ. MATERIALS AND METHODS 2 Ⅲ. RESULTS 3 Ⅳ. DISCUSSION 11 Ⅴ. CONCLUSION 13 REFERENCES 14 국문요약 18 Master 2015-11-02 2015-11-02 2015 2015 Thesis Theses http://repository.ajou.ac.kr/handle/201003/11871 http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000020339 000000020339 en