| 史晓如,孙玉峰,王 昊,鲍 安,董秉政.术前肌酐/胱抑素C比值、血红蛋白/红细胞分布宽度比值对非转移性肾细胞癌患者预后的影响[J].,2025,(1):112-118 |
| 术前肌酐/胱抑素C比值、血红蛋白/红细胞分布宽度比值对非转移性肾细胞癌患者预后的影响 |
| Effect of Preoperative Creatinine/Cystatin C Ratio and Hemoglobin/Red Blood Cell Distribution Width Ratio on the Prognosis of Patients with Non-Metastatic Renal Cell Carcinoma |
| 投稿时间：2024-08-19 |
| DOI：10.13241/j.cnki.pmb.2025.01.016 |
| 中文关键词: 非转移性肾细胞癌 肌酐/胱抑素C比值 血红蛋白/红细胞分布宽度比值 预后 |
| 英文关键词: Non-metastatic renal cell carcinoma Creatinine/cystatin C ratio Hemoglobin/red blood cell distribution width ratio Prognosis |
| 基金项目:江苏省医学创新团队培养项目（CXTDA2017048） |
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| 中文摘要: |
| 摘要 目的：探讨术前肌酐/胱抑素C比值（CCR）、血红蛋白/红细胞分布宽度比值（HRR）对非转移性肾细胞癌（RCC）患者预后的影响。方法：选取2019年1月至2021年1月期间在徐州市中心医院接受肾部分切除术或根治性肾切除术的129例非转移性RCC患者，检测术前外周血中血红蛋白、红细胞分布宽度和血清肌酐、胱抑素C水平，计算CCR和HRR。采用受试者工作特征（ROC）曲线确定术前血清CCR、外周血HRR的最佳截断值，根据CCR和HRR截断值分组。比较不同水平血清CCR、外周血HRR患者临床病理特征的差异，采用Kaplan-Meier法绘制术后生存曲线分析不同水平血清CCR、外周血HRR患者生存差异，单因素和多因素COX风险比例回归模型分析非转移性RCC患者预后的影响因素。结果：随访3年期间失访3例，存活91例，死亡35例。术前血清CCR、外周血HRR预测非转移性RCC患者术后生存的最佳截断值分别为0.88、0.94，据此将患者分为高CCR组（59例）和低CCR组（67例），高HRR组（54例）和低HRR组（72例）。低CCR组和低HRR组Fuhrman分级Ⅲ～Ⅳ级、TNM分期Ⅲ期、淋巴结转移比例分别高于高CCR组和高HRR组（P＜0.05）。低CCR组、低HRR组非转移性RCC患者3年总生存（OS）率分别低于高CCR组、高HRR组患（P＜0.05）。低CCR、低HRR、TNM分期Ⅲ期、淋巴结转移是非转移性RCC患者预后不良的危险因素（P＜0.05）。结论：非转移性RCC患者术前CCR和HRR与Fuhrman分级、TNM分期、淋巴结转移情况等病理特征以及预后不良有关，能有效评估RCC患者预后。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of preoperative creatinine/cystatin C ratio (CCR) and hemoglobin/red blood cell distribution width ratio (HRR) on the prognosis of patients with non-metastatic renal cell carcinoma (RCC). Methods: 129 non-metastatic RCC patients who underwent partial nephrectomy or radical nephrectomy in Xuzhou Central Hospital from January 2019 to January 2021 were selected, the levels of hemoglobin, red blood cell distribution width, serum creatinine and cystatin C in peripheral blood were detected before operation, and CCR and HRR were calculated. The optimal cut-off values of preoperative serum CCR and peripheral blood HRR were determine by receiver operating characteristic (ROC) curve, and the patients were grouped according to the cut-off values of CCR and HRR. The clinicopathological characteristics of patients with different levels of serum CCR and peripheral blood HRR were compared. Kaplan-Meier method was used to draw postoperative survival curves to analyze the survival differences of patients with different levels of serum CCR and peripheral blood HRR. The prognostic factors of non-metastatic RCC patients were analyzed by univariate and multivariate COX risk proportional regression model. Results: During the 3-year follow-up period, 3 cases were lost to follow-up, 91 cases survived, and 35 cases died. The optimal cut-off values of preoperative serum CCR and peripheral blood HRR for predicting postoperative survival of non-metastatic RCC patients were 0.88 and 0.94, respectively, patients were divided into high CCR group (59 cases) and low CCR group (67 cases), high HRR group (54 cases) and low HRR group (72 cases) according to this. The proportions of Fuhrman grade III-IV, TNM stage III and lymph node metastasis in low CCR group and low HRR group were higher than those in high CCR group and high HRR group (P<0.05). The 3-year overall survival (OS) rate of non-metastatic RCC patients in low CCR group and low HRR group was lower than that in high CCR group and high HRR group, respectively (P<0.05). Low CCR, low HRR, TNM stage III and lymph node metastasis were risk factors for poor prognosis in non-metastatic RCC patients (P<0.05). Conclusion: Preoperative CCR and HRR in patients with non-metastatic RCC are related to pathological features such as Fuhrman grade, TNM stage, lymph node metastasis, as well as poor prognosis, which can effectively evaluate the prognosis of RCC patients. |
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