临床外科杂志 ›› 2024, Vol. 32 ›› Issue (5): 532-536.doi: 10.3969/j.issn.1005-6483.2024.05.026

• 论著 • 上一篇    下一篇

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

  

  1. 150081  哈尔滨医科大学附属肿瘤医院泌尿外科(李浩、张鹤骞、滕立臣);黑龙江省齐齐哈尔市第一医院(于莹莹、宋祥伟)
  • 收稿日期:2023-04-11 修回日期:2023-04-11 接受日期:2023-04-11 出版日期:2024-05-25 发布日期:2024-05-25
  • 通讯作者: 滕立臣,Email:tenglichen@2008.sina.com
  • 基金资助:
    哈尔滨医科大学附属肿瘤医院海燕基金(NO.JJMS 2022-14)

Study on the predictive value of preoperative peripheral blood inflammatory related indexes in Fuhrman grade of clear cell renal cell carcinoma

  1. Department of Urology,Harbin Medical University Cancer Hospital,Heilongjiang,Harbin 150081,China
  • Received:2023-04-11 Revised:2023-04-11 Accepted:2023-04-11 Online:2024-05-25 Published:2024-05-25

摘要: 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。

关键词: 肾细胞癌, 炎症指标, Furhman分级, 预测价值

Abstract: 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.

Key words: renal cell carcinoma, inflammatory indexes, Furhman grade, predictive value

[1] 张嘉员 肖长芳 姚一博. 简化弗尔涅坏疽严重性指数量表判断肛周坏死性筋膜炎预后的临床价值[J]. 临床外科杂志, 2023, 31(6): 524-527.
[2] 熊祥云 丁佑铭 苏洋. 术前炎症指标预测肝移植术后感染的价值[J]. 临床外科杂志, 2023, 31(5): 457-460.
[3] 魏萌萌 吕志坤 李国珍 胡雪艳 许倩倩 郭静 耿彪. 血清血管生成素样蛋白8、血管细胞黏附分子-1水平联合检测对颅内动脉瘤栓塞术后脑血管痉挛的预测价值[J]. 临床外科杂志, 2023, 31(12): 1133-1136.
[4] 孙会群 马熙 高星. 腹腔镜结直肠癌根治术前病人外周血穿透素联合miR-486-3p水平预测术后复发转移的价值探讨[J]. 临床外科杂志, 2023, 31(10): 954-958.
[5] 李锦楠 崔亮 肖旭仁 吴学杰 代晓飞 李景敏. 人源性肾癌异体移植模型的建立及分析[J]. 临床外科杂志, 2022, 30(8): 767-770.
[6] 胡明玉 苗祥 潘书鸿. 改良结肠渗漏评分对左结肠直肠手术病人吻合口漏的预测价值[J]. 临床外科杂志, 2022, 30(2): 175-178.
[7] 戴津东, 张兴明, 曾浩. 转移性肾癌减瘤性肾切除术的临床决策要点及挑战[J]. 临床外科杂志, 2021, 29(2): 112-116.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 王宇;嵇庆海;李端树等. 甲状腺癌侧颈淋巴结清扫易遗漏的区域与对策[J]. 临床外科杂志, 2017, 25(11): 805 .
[2] 丁慧勇;侯彦杰;阿布力米提·阿木提. 改良骨刀截骨椎板棘突复合体回植治疗腰椎管狭窄症[J]. 临床外科杂志, 2017, 25(3): 216 .
[3] 魏征, 胡仁旺. 肝脏多发血管瘤术前诊断为肝胆管囊腺癌一例[J]. 临床外科杂志, 2019, 27(2): 124 -125 .
[4] 吴迅. 不同手术方式治疗高龄前列腺增生的疗效及对术后前列腺功能的影响[J]. 临床外科杂志, 2019, 27(2): 173 -175 .
[5] 杨亚芳, 段克举, 刘真真, 崔树德. 乳腺数字化摄影中微钙化的临床分析[J]. 临床外科杂志, 2019, 27(3): 223 -226 .
[6] 谢孝枫, 郑斌, 顾雪平, 王文晔. 股骨内外髁切迹定位全膝关节置换术中股骨髓内插入点的解剖学分析[J]. 临床外科杂志, 2019, 27(4): 305 -308 .
[7] 霍振清, 罗后宙, 梁冰等. miR-375,EPCA-2联合PSA对早期前列腺癌的诊断价值研究[J]. 临床外科杂志, 2019, 27(9): 809 -812 .
[8] 王鹏, 席树强. 腹腔镜下胆囊切除术后并发肠粘连的危险因素分析[J]. 临床外科杂志, 2019, 27(12): 1024 -1027 .
[9] 陶海鹰, 杨博, 卫爱林, 杨俭. Centerpiece钛板系统治疗多节段脊髓型颈椎病的早期疗效分析[J]. 临床外科杂志, 2019, 27(12): 1060 -1062 .
[10] 胡丽娟, 戴奇山, 胡建波. 前列腺癌骨转移病人唑来膦酸不同给药间期疗效比较[J]. 临床外科杂志, 2020, 28(5): 472 -475 .