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