Preoperative neutrophil–lymphocyte ratio/platelet–lymphocyte ratio: A potential and economical marker for renal cell carcinoma
Deepika Chandrasekaran1, Sandhya Sundaram2, K Maheshkumar3, N Kathiresan4, R Padmavathi1
1 Department of Physiology, Sri Ramachandra Institute of Higher Education and Research, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
2 Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
3 Department of Physiology and Biochemistry, Government Yoga and Naturopathy Medical College and Hospital, Chennai, Tamil Nadu, India
4 Department of Surgical Oncology, Apollo Speciality Hospital, Chennai, Tamil Nadu, India
Department of Physiology, Sri Ramachandra Institute of Higher Education and Research, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu
Source of Support: None, Conflict of Interest: None
Background: Emerging evidences have elucidated the crucial role of inflammation in carcinogenesis and tumor progression. In the recent years, many inflammatory biomarkers showed promising prognostic factors in renal cell carcinoma (RCC). We intended to evaluate the significance of one such inflammatory factor which is potential, noninvasive, simple, as well as economical. The preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in RCC patients have shown favorable results.
Objective: The objective was to assess the prognostic role of NLR/PLR in the advanced stage and high-grade RCC.
Subjects and Methods: This is a retrospective study. Ethical clearance was obtained from the institute ethics committee. One hundred and fifty histopathologically proven RCC cases during the period of January 2010–September 2018 were chosen from the pathology department and corresponding blood reports were obtained from the medical records department. We divided the cases based on their staging and grading. NLR/PLR values were calculated using formulas.
Statistical Analysis: Statistical analysis was done using R software. Data were expressed as mean ± standard deviation, median, and percentage. Independent t-test, Mann–Whitney test, and Chi-square test were used. P < 0.05 was considered statistically significant. The receiver operating characteristic curve (ROC) was plotted to assess the sensitivity of NLR/PLR.
Results: The elevated NLR/PLR values showed a significant relation with high-grade and advanced stage RCC. The ROC curve proved the accuracy of NLR/PLR in the advanced stage and high-grade RCC.
Limitations: A multicentric, prospective study can be planned in the future. Follow-up studies are needed to assess their prognostic role.
Conclusion: NLR/PLR values can become part of routine investigations for all RCC patients. The values may help to estimate pathological outcomes, chance of recovery, recurrence, and survival rates.