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目的:探讨术前血清中性粒细胞数目在肾透明细胞癌(Clear Cell Renal Cell Carcinoma,CCRCC)患者预后中的价值。方法:收集142例手术切除CCRCC患者术前血清中性粒细胞计数以及年龄、性别、TNM分期等临床病理资料,并分析其与CCRCC预后的相关性。结果:低中性粒细胞组和高中性粒细胞组患者分别为70和72例,总的五年生存率为93.6%。多因素Cox回归分析提示TNM分期(P=0.009,HR 5.683,95%CI 1.463-19.548)、肿瘤坏死(P=0.003,HR 6.027,95%CI 2.118-15.702)、脉管侵犯(P=0.006,HR 3.347,95%CI 1.012-9.918)和中性粒细胞水平(P=0.004,HR 5.863,95%CI 1.821-17.961)均是CCRCC患者预后独立因素;Kaplan-Meier生存曲线提示CCRCC患者术前血清中低中性粒细胞水平的患者预后好于高中性粒细胞水平的患者(P=0.009)。结论:术前患者血清中性粒细胞水平对评价CCRCC的预后有重要意义。中性粒细胞低水平的患者相比高水平的预后较好。
Objective: To investigate the value of preoperative serum neutrophil count in the prognosis of patients with clear cell renal cell carcinoma (CCRCC). Methods: Preoperative serum neutrophil count, age, gender and TNM stage were collected from 142 patients with resected CCRCC. Clinicopathological data were collected and their correlation with prognosis of CCRCC was analyzed. Results: There were 70 and 72 patients in the low neutrophil and high neutrophil groups, respectively. The overall 5-year survival rate was 93.6%. Multivariate Cox regression analysis showed that TNM stage (P = 0.009, HR 5.683, 95% CI 1.463-19.548), tumor necrosis (P = 0.003, HR 6.027, 95% CI 2.118-15.702) HR 3.347,95% CI 1.012-9.918) and neutrophil levels (P = 0.004, HR 5.863,95% CI 1.821-17.961) were independent prognostic factors in patients with CCRCC; Kaplan-Meier survival curves suggest that CCRCC patients preoperative serum Patients with low-neutrophil levels had a better prognosis than those with high neutrophil levels (P = 0.009). Conclusion: Preoperative serum neutrophil level is of great importance in evaluating the prognosis of CCRCC. Patients with low neutrophil levels have a better prognosis than high levels.