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Impact of diabetes mellitus on the prognostic value of the neutrophil‑lymphocyte ratio in renal cell carcinoma

  • Authors:
    • Yangqin Zheng
    • Lian Min Bao
    • Junjie Ye
    • Yue Pan
    • Qinquan Wang
    • Xiaomin Gao
  • View Affiliations / Copyright

    Affiliations: Department of Hematology, The Third Clinical Institute Affiliated to Wenzhou Medical University, People's Hospital of Wenzhou, Wenzhou, Zhejiang 325006, P.R. China, Department of Respiratory Medicine, Ruian People's Hospital, The Third Affiliated Hospital of The Wenzhou Medical University, Wenzhou, Zhejiang 325200, P.R. China, Department of Urology, Sixth Affiliated Hospital of Wenzhou Medical University, Lishui People's Hospital, Lishui, Zhejiang 323000, P.R. China, Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325006, P.R. China, Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, P.R. China
    Copyright: © Zheng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 1268-1275
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    Published online on: December 13, 2018
       https://doi.org/10.3892/etm.2018.7093
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Abstract

The aim of the present study was to evaluate the effect of diabetes mellitus (DM) on the neutrophil‑lymphocyte ratio (NLR)‑based prediction of the prognosis of patients with renal cell carcinoma (RCC). The data of 662 patients who had undergone nephrectomy for RCC between January 2004 and July 2014 were retrospectively reviewed. X‑tile analysis was used to determine the optimal cutoff value for the NLR. Kaplan‑Meier curves were drawn and the log‑rank test was applied to determine the impact of the NLR (high vs. low) on the overall survival (OS) and metastasis‑free survival (MFS). Univariate and multivariate Cox regression analyses were used to identify prognostic factors for OS and MFS. The median follow‑up period after surgery was 50.35 months (range, 30.30‑85.08 months). The optimal cutoff value of the NLR was determined to be 3.2 using X‑tile software. In the analysis of total subjects, patients with a high NLR (≥3.2) had significantly worse OS and MFS rates than those with a low NLR (<3.2) (21.60% vs. 78.40%, P=0.001 for OS and 21.60% vs. 78.40%, P<0.0001 for MFS). In the non‑DM subgroup, the OS and MFS rates of patients with a high NLR were significantly worse compared with those of patients with a low NLR (21.69% vs. 78.31%, P=0.003 for OS and 21.69% vs. 78.31%, P<0.001 for MFS). In the DM subgroup, although a high NLR was still associated with the MFS (NLR≥3.2, 21.43% vs. NLR<3.2, 78.57%; P=0.015), it was no longer associated with the OS (NLR≥3.2, 21.43% vs. NLR<3.2, 78.57%; P=0.192). Furthermore, multivariate analysis identified the NLR as a risk factor for OS and MFS in all patients [hazard ratio (HR)=1.77, 95% confidence interval (CI): 1.04‑3.01, P=0.037; and HR=2.31, 95% CI: 1.45‑3.70, P<0.001, respectively) and in the non‑DM subgroup (HR=2.03, 95% CI: 1.05‑3.93, P=0.036; and HR=2.57, 95% CI: 1.47‑4.49, P=0.001, respectively), but not in the DM subgroup (P>0.05). In conclusion, DM is a factor that impairs the evaluation of the prognosis of RCC using NLR.
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View References

1 

Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, Leibowitz-Amit R, Sonpavde G, Knox JJ, Tran B, et al: Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: A systematic review and meta-analysis. J Natl Cancer Inst. 106:dju1242014. View Article : Google Scholar : PubMed/NCBI

2 

Xue TC, Zhang L, Xie XY, Ge NL, Li LX, Zhang BH, Ye SL and Ren ZG: Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: A meta-analysis. PLoS One. 9:e960722014. View Article : Google Scholar : PubMed/NCBI

3 

Walsh SR, Cook EJ, Goulder F, Justin TA and Keeling NJ: Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 91:181–184. 2005. View Article : Google Scholar : PubMed/NCBI

4 

Kang MH, Go SI, Song HN, Lee A, Kim SH, Kang JH, Jeong BK, Kang KM, Ling H and Lee GW: The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer. Br J Cancer. 111:452–460. 2014. View Article : Google Scholar : PubMed/NCBI

5 

Lieto E, Galizia G, Auricchio A, Cardella F, Mabilia A, Basile N, Del Sorbo G, Castellano P, Romano C, Orditura M and Napolitano V: Preoperative neutrophil to lymphocyte ratio and lymphocyte to monocyte ratio are prognostic factors in gastric cancers undergoing surgery. J Gastrointest Surg. 21:1764–1774. 2017. View Article : Google Scholar : PubMed/NCBI

6 

Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT and Lee K: Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 58:15–23. 2009. View Article : Google Scholar : PubMed/NCBI

7 

Hu H, Yao X, Xie X, Wu X, Zheng C, Xia W and Ma S: Prognostic value of preoperative NLR, dNLR, PLR and CRP in surgical renal cell carcinoma patients. World J Urol. 35:261–270. 2017. View Article : Google Scholar : PubMed/NCBI

8 

Ohno Y, Nakashima J, Ohori M, Hatano T and Tachibana M: Pretreatment neutrophil-to-lymphocyte ratio as an independent predictor of recurrence in patients with nonmetastatic renal cell carcinoma. J Urol. 184:873–878. 2010. View Article : Google Scholar : PubMed/NCBI

9 

Cetin B, Berk V, Kaplan MA, Afsar B, Tufan G, Ozkan M, Isikdogan A, Benekli M, Coskun U and Buyukberber S: Is the pretreatment neutrophil to lymphocyte ratio an important prognostic parameter in patients with metastatic renal cell carcinoma? Clin Genitourin Cancer. 11:141–148. 2013. View Article : Google Scholar : PubMed/NCBI

10 

Fox P, Hudson M, Brown C, Lord S, Gebski V, De Souza P and Lee CK: Markers of systemic inflammation predict survival in patients with advanced renal cell cancer. Br J Cancer. 109:147–153. 2013. View Article : Google Scholar : PubMed/NCBI

11 

Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL and Zincke H: An outcome prediction model for patients with clear cell renal cell carcinoma treated with radical nephrectomy based on tumor stage, size, grade and necrosis: The SSIGN score. J Urol. 168:2395–2400. 2002. View Article : Google Scholar : PubMed/NCBI

12 

Leibovich BC, Blute ML, Cheville JC, Lohse CM, Frank I, Kwon ED, Weaver AL, Parker AS and Zincke H: Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: A stratification tool for prospective clinical trials. Cancer. 97:1663–1671. 2003. View Article : Google Scholar : PubMed/NCBI

13 

Patard JJ, Kim HL, Lam JS, Dorey FJ, Pantuck AJ, Zisman A, Ficarra V, Han KR, Cindolo L, De La Taille A, et al: Use of the University of California Los Angeles integrated staging system to predict survival in renal cell carcinoma: An international multicenter study. J Clin Oncol. 22:3316–3322. 2004. View Article : Google Scholar : PubMed/NCBI

14 

Karakiewicz PI, Suardi N, Capitanio U, Jeldres C, Ficarra V, Cindolo L, de la Taille A, Tostain J, Mulders PF, Bensalah K, et al: A preoperative prognostic model for patients treated with nephrectomy for renal cell carcinoma. Eur Urol. 55:287–295. 2009. View Article : Google Scholar : PubMed/NCBI

15 

Lou M, Luo P, Tang R, Peng Y, Yu S, Huang W and He L: Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocr Disord. 15:92015. View Article : Google Scholar : PubMed/NCBI

16 

Shiny A, Bibin YS, Shanthirani CS, Regin BS, Anjana RM, Balasubramanyam M, Jebarani S and Mohan V: Association of neutrophil-lymphocyte ratio with glucose intolerance: An indicator of systemic inflammation in patients with type 2 diabetes. Diabetes Technol Ther. 16:524–530. 2014. View Article : Google Scholar : PubMed/NCBI

17 

Larsson SC and Wolk A: Diabetes mellitus and incidence of kidney cancer: A meta-analysis of cohort studies. Diabetologia. 54:1013–1018. 2011. View Article : Google Scholar : PubMed/NCBI

18 

Bao C, Yang X, Xu W, Luo H, Xu Z, Su C and Qi X: Diabetes mellitus and incidence and mortality of kidney cancer: A meta-analysis. J Diabetes Complications. 27:357–364. 2013. View Article : Google Scholar : PubMed/NCBI

19 

Balkwill FR and Mantovani A: Cancer-related inflammation: Common themes and therapeutic opportunities. Semin Cancer Biol. 22:33–40. 2012. View Article : Google Scholar : PubMed/NCBI

20 

Chan AT, Ogino S and Fuchs CS: Aspirin and the risk of colorectal cancer in relation to the expression of COX-2. N Eng J Med. 356:2131–2142. 2007. View Article : Google Scholar

21 

Sparmann A and Bar-Sagi D: Ras-induced interleukin-8 expression plays a critical role in tumor growth and angiogenesis. Cancer Cell. 6:447–458. 2004. View Article : Google Scholar : PubMed/NCBI

22 

Stoppacciaro A, Melani C, Parenza M, Mastracchio A, Bassi C, Baroni C, Parmiani G and Colombo MP: Regression of an established tumor genetically modified to release granulocyte colony-stimulating factor requires granulocyte-T cell cooperation and T cell-produced interferon gamma. J Exp Med. 178:151–161. 1993. View Article : Google Scholar : PubMed/NCBI

23 

Avci A, Elnur A, Göksel A, Serdar F, Servet I, Atilla K, Mustafa TM, Cuneyt T, Yeliz G, Mustafa B and Metin EA: The relationship between neutrophil/lymphocyte ratio and calcific aortic stenosis. Echocardiography. 31:1031–1035. 2014. View Article : Google Scholar : PubMed/NCBI

24 

Balta S, Demirkol S, Kucuk U, Celik T, Ozturk C and Iyisoy A: The relationship between neutrophil-lymphocyte ratio and coronary collateral circulation. Perfusion. 29:367–368. 2014. View Article : Google Scholar : PubMed/NCBI

25 

Yao C, Liu X and Tang Z: Prognostic role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for hospital mortality in patients with AECOPD. Int J Chron Obstruct Pulmon Dis. 12:2285–2290. 2017. View Article : Google Scholar : PubMed/NCBI

26 

Demir M: The relationship between neutrophil lymphocyte ratio and non-dipper hypertension. Clin Exp Hypertens. 35:570–573. 2013. View Article : Google Scholar : PubMed/NCBI

27 

Ha YS, Kim WT, Yun SJ, Lee SC, Kim WJ, Park YH, Kang SH, Hong SH, Byun SS and Kim YJ: Multi-institutional analysis of localized renal cell carcinoma that demonstrates the impact of diabetic status on prognosis after nephrectomy. Ann Surg Oncol. 20:3662–3668. 2013. View Article : Google Scholar : PubMed/NCBI

28 

Chen L, Li H, Gu L, Ma X, Li X, Gao Y, Zhang Y, Shen D, Fan Y, Wang B, et al: The impact of diabetes mellitus on renal cell carcinoma prognosis: A meta-analysis of cohort studies. Medicine (Baltimore). 94:e10552015. View Article : Google Scholar : PubMed/NCBI

29 

Boissier R, Campagna J, Branger N, Karsenty G and Lechevallier E: The prognostic value of the neutrophil-lymphocyte ratio in renal oncology: A review. Urol Oncol. 35:135–141. 2017. View Article : Google Scholar : PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Zheng Y, Bao LM, Ye J, Pan Y, Wang Q and Gao X: Impact of diabetes mellitus on the prognostic value of the neutrophil‑lymphocyte ratio in renal cell carcinoma. Exp Ther Med 17: 1268-1275, 2019.
APA
Zheng, Y., Bao, L.M., Ye, J., Pan, Y., Wang, Q., & Gao, X. (2019). Impact of diabetes mellitus on the prognostic value of the neutrophil‑lymphocyte ratio in renal cell carcinoma. Experimental and Therapeutic Medicine, 17, 1268-1275. https://doi.org/10.3892/etm.2018.7093
MLA
Zheng, Y., Bao, L. M., Ye, J., Pan, Y., Wang, Q., Gao, X."Impact of diabetes mellitus on the prognostic value of the neutrophil‑lymphocyte ratio in renal cell carcinoma". Experimental and Therapeutic Medicine 17.2 (2019): 1268-1275.
Chicago
Zheng, Y., Bao, L. M., Ye, J., Pan, Y., Wang, Q., Gao, X."Impact of diabetes mellitus on the prognostic value of the neutrophil‑lymphocyte ratio in renal cell carcinoma". Experimental and Therapeutic Medicine 17, no. 2 (2019): 1268-1275. https://doi.org/10.3892/etm.2018.7093
Copy and paste a formatted citation
x
Spandidos Publications style
Zheng Y, Bao LM, Ye J, Pan Y, Wang Q and Gao X: Impact of diabetes mellitus on the prognostic value of the neutrophil‑lymphocyte ratio in renal cell carcinoma. Exp Ther Med 17: 1268-1275, 2019.
APA
Zheng, Y., Bao, L.M., Ye, J., Pan, Y., Wang, Q., & Gao, X. (2019). Impact of diabetes mellitus on the prognostic value of the neutrophil‑lymphocyte ratio in renal cell carcinoma. Experimental and Therapeutic Medicine, 17, 1268-1275. https://doi.org/10.3892/etm.2018.7093
MLA
Zheng, Y., Bao, L. M., Ye, J., Pan, Y., Wang, Q., Gao, X."Impact of diabetes mellitus on the prognostic value of the neutrophil‑lymphocyte ratio in renal cell carcinoma". Experimental and Therapeutic Medicine 17.2 (2019): 1268-1275.
Chicago
Zheng, Y., Bao, L. M., Ye, J., Pan, Y., Wang, Q., Gao, X."Impact of diabetes mellitus on the prognostic value of the neutrophil‑lymphocyte ratio in renal cell carcinoma". Experimental and Therapeutic Medicine 17, no. 2 (2019): 1268-1275. https://doi.org/10.3892/etm.2018.7093
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