术前免疫细胞指标在有肿瘤血栓的肾细胞癌中的作用。

IF 0.8 Q4 UROLOGY & NEPHROLOGY Urologia Journal Pub Date : 2024-08-01 Epub Date: 2024-04-25 DOI:10.1177/03915603241248020
Maxwell Sandberg, Mary Namugosa, Rory Ritts, Claudia Marie Costa, Davis Temple, Mitchell Hayes, Wyatt Whitman, Emily Ye, Justin Refugia, Reuben Ben-David, Parissa Alerasool, Benjamin Eilender, Rafael Ribeiro Zanotti, Thiago Camelo Mourão, Jung Kwon Kim, Patricio Garcia Marchiñena, Seok-Soo Byun, Diego Abreu, Reza Mehrazin, Philippe Spiess, Stenio de Cassio Zequi, Alejandro Rodriguez
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引用次数: 0

摘要

导言:本研究的目的是根据肾细胞癌(RCC)和肿瘤血栓患者接受根治性肾切除术和肿瘤血栓切除术后的癌症特异性结果对术前免疫细胞计数进行分层:方法:纳入在由七家机构组成的国际联盟中接受根治性肾切除术和肿瘤血栓切除术的确诊为RCC和肿瘤血栓的患者。还包括诊断时已转移的患者和接受术前药物治疗的患者。研究人员对病历进行了回顾性审查,以收集人口统计学信息、既往病史、术前实验室检查、手术病理和随访数据。采用独立样本 t 检验、皮尔森双变量相关性和方差分析,将中性粒细胞计数、淋巴细胞计数、单核细胞计数、中性粒细胞与淋巴细胞比率(NLR)、淋巴细胞与单核细胞比率(LMR)和中性粒细胞与单核细胞比率(NMR)与癌症特异性结果进行比较:研究共纳入 144 名患者,其中包括 9 名手术时已转移的患者。死于 RCC 的患者术前绝对淋巴细胞计数高于未死患者(2 vs 1.4; p p = 0.010)。与没有转移的患者相比,转移性 RCC 患者术后的 LMR 更低(2.5 对 3.2;P = 0.041)。术前和大体标本上的肿瘤大小与多个免疫细胞指标之间存在相互作用(p 结论:术前免疫指标与大体标本上的肿瘤大小之间存在相互作用:术前免疫指标在预测RCC和肿瘤血栓患者的癌症特异性预后方面具有临床实用性。还需要进行更多研究,以确定术前血清免疫细胞数据对这一患者群体既有预后风险计算器的附加价值。
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The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus.

Introduction: The objective of this study was to stratify preoperative immune cell counts by cancer specific outcomes in patients with renal cell carcinoma (RCC) and a tumor thrombus after radical nephrectomy with tumor thrombectomy.

Methods: Patients with a diagnosis of RCC with tumor thrombus that underwent radical nephrectomy with thrombectomy across an international consortium of seven institutions were included. Patients who were metastatic at diagnosis and those who received preoperative medical treatment were also included. Retrospective chart review was performed to collect demographic information, past medical history, preoperative lab work, surgical pathology, and follow up data. Neutrophil counts, lymphocyte counts, monocyte counts, neutrophil to lymphocyte ratios (NLR), lymphocyte to monocyte ratios (LMR), and neutrophil to monocyte ratios (NMR) were compared against cancer-specific outcomes using independent samples t-test, Pearson's bivariate correlation, and analysis of variance.

Results: One hundred forty-four patients were included in the study, including nine patients who were metastatic at the time of surgery. Absolute lymphocyte count preoperatively was greater in patients who died from RCC compared to those who did not (2 vs 1.4; p < 0.001). Patients with tumor pathology showing perirenal fat invasion had a greater neutrophil count compared to those who did not (7.5 vs 5.5; p = 0.010). Patients with metastatic RCC had a lower LMR compared to those without metastases after surgery (2.5 vs 3.2; p = 0.041). Tumor size, both preoperatively and on gross specimen, had an interaction with multiple immune cell metrics (p < 0.05).

Conclusions: Preoperative immune metrics have clinical utility in predicting cancer-specific outcomes for patients with RCC and a tumor thrombus. Additional study is needed to determine the added value of preoperative serum immune cell data to established prognostic risk calculators for this patient population.

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来源期刊
Urologia Journal
Urologia Journal UROLOGY & NEPHROLOGY-
CiteScore
0.60
自引率
12.50%
发文量
66
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