Can preoperative neutrophil lymphocyte ratio predict malignancy in patients undergoing partial nephrectomy because of renal mass?

Görgel, Sacit Nuri; Ozer, Kutan; Köse, Osman; Dindar, Ahmet Selçuk

doi:10.1590/s1677-5538.ibju.2017.0225

Cited by 6 publications

(10 citation statements)

References 33 publications

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“…We found that the NLR levels were higher in the RCC group, which can reflect the status of the tumor microenvironment. Similarly to our study, a number of researchers have demonstrated that the preoperative NLR value was significantly higher in malignant renal masses compared to benign ones [8,13,14].…”

Section: Discussionsupporting

confidence: 87%

Preoperative hemogram-related parameters to distinguish renal cell carcinoma from benign kidney masses: HERR score

Türkoğlu

Üstündağ

2019

The European Research Journal

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Objectives: Renal cell carcinoma (RCC) accounts for approximately 90% of all kidney malignancies, and it is difficult to preoperatively distinguish between tumors and benign masses without a kidney biopsy in small renal masses. We investigated whether any preoperatively defined hemogram-related parameters had a predictive value that would distinguish RCC from benign kidney masses using a novel scoring method. Methods: Between January 2011 and November 2017, 330 patients diagnosed with kidney masses and who received an operation were included. Fifty-six masses were benign. The neutrophil-to-lymphocyte count (NLR), platelet-to-lymphocyte count, lymphocyte-to-monocyte count, mean platelet volume, platelet count ratio, and hemoglobin to red cell distribution width ratios were calculated. The hemogram-related parameters were combined with the tumor size to establish the hemogram-related risk (HERR) score. The area under the receiver operating characteristics curve, sensitivity, specificity, and likelihood ratios were evaluated to preoperatively diagnose RCC. Results: Histological findings confirmed RCC in 274 patients. The NLR [median (interquartile range)] was higher in patients with RCC, 3.7 (4.7), compared to a benign kidney mass, 2.4 (2.2) (p < 0.001). A HERR score cutoff of ≥ 3 showed a good sensitivity at 78% with an LR+ of 10.8 [95% confidence interval (CI): 7.0-16.4] and an LR-of 1.2 (95% CI: 1.0-1.5). Conclusion: Our study, despite being a preliminary validation, is the first to evaluate hemogram-related parameters for preoperatively discriminating between RCC and benign renal masses, and the HERR score serves as a potential diagnostic biomarker for this

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Section: Discussionsupporting

confidence: 87%

Preoperative hemogram-related parameters to distinguish renal cell carcinoma from benign kidney masses: HERR score

Türkoğlu

Üstündağ

2019

The European Research Journal

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“…Preoperative NLR of the patients with clear cell RCC was significantly higher (p<0.001). However, NLR was not associated with the tumor grade as well as the size of the mass (28).…”

Section: Discussionmentioning

confidence: 76%

Neutrophil-Lymphocyte Ratio is Valuable in Predicting the Pathology Result in the Patients with Renal Mass > 4 cm Prior to the Partial Nephrectomy

Çağlayan¹,

Önen²,

Avcı³

et al. 2019

Kocaeli Med J

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“…Identifying pathological properties by preoperative imaging would contribute to reduce unnecessary ureteroscopy biopsy, intraoperative ureteral exploration, and RNU, which might result in tumor cell dissemination ( 3 ). However, using traditional radiological methods to distinguish benign or malignant tumors occasionally lead to inappropriate surgical decisions ( 32 ). It is reported that about 2.9%–12.8% of suspected UUT masses were finally confirmed as benign lesions after RNU ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…NLR is defined as the ratio of neutrophil to lymphocyte count in peripheral blood ( 32 ). Compared with CTCs, NLR is economic, repeatable, and easy to measure, which could be widely used in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphopenia may lead to a poor immune response to tumors, which is conducive to tumor aggressiveness and progression. Thus, high NLR level indicates a decrease in lymphocyte-mediated anti-tumor immune responses and an increase in neutrophil-dependent inflammatory responses, which might lead to cancer invasiveness, progression, and poor prognosis ( 24 , 32 , 34 , 35 ).…”

Section: Discussionmentioning

confidence: 99%

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Role of 18F-FDG-PET/CT in Combination With Neutrophil–Lymphocyte Ratio in the Diagnosis of Upper Urinary Tract Lesion: Can We Accurately Predict Malignant Tumor?

Lin

Chen

et al. 2021

Front. Oncol.

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ObjectiveTo explore whether preoperative 18Fluorine-Fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) in combination with neutrophil–lymphocyte ratio (NLR) could accurately predict malignant lesions of upper urinary tract (UUT).Methods and MaterialsThe clinicopathologic data of a total of 252 patients with UUT lesions receiving surgical treatment at our center from January 2012 to November 2019 were retrospectively analyzed. All patients performed routine preoperative hematological examination, urine cytology, computed tomography urography (CTU), and 18F-FDG-PET/CT. Clinicopathologic data between 179 cases with malignancy (Group 1) and 73 cases with benign lesions (Group 2) were compared. Multivariate logistic regression analysis was used to explore the independent predictors of malignant UUT lesions. Receiver operating characteristic (ROC) curve was used to evaluate the predictive ability.ResultsAmong all patients, univariate analysis showed that NLR, hydronephrosis, CTU indicating malignancy, and PET/CT indicating malignancy were significantly associated with malignant UUT lesions; multivariate analysis revealed that NLR, CTU indicating malignancy, and PET/CT indicating malignancy were independent predictors of malignant UUT lesions; the area under ROC curve (AUC) of NLR, CTU, PET/CT, combining CTU and NLR, combining PET/CT and NLR, and combining PET/CT and CTU were 0.735, 0.788, 0.857, 0.863, 0.913, and 0.919, respectively, for postoperative pathological malignancy. Among 68 patients undergoing ureteroscopy biopsy, univariate analysis suggested that NLR, positive urine exfoliation cytology, CTU indicating malignancy, and PET/CT indicating malignancy were significantly associated with malignant UUT lesions; multivariate analysis demonstrated that positive urine cytology, PET/CT indicating malignancy, and NLR were independent predictors of malignant UUT lesions; the AUC of NLR, ureteroscopy biopsy, and combining PET/CT and NLR were 0.768, 0.853, and 0.839, respectively, for postoperative pathological malignancy.ConclusionsCombining preoperative NLR and PET/CT performed well in differentiating benign from malignant UUT lesions, which could not be identified by traditional imaging or urine cytology. Combining preoperative NLR and PET/CT could be used to reduce unnecessary ureteroscopy biopsy, which might result in tumor cell dissemination and risk of associated complications.

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Can preoperative neutrophil lymphocyte ratio predict malignancy in patients undergoing partial nephrectomy because of renal mass?

Cited by 6 publications

References 33 publications

Preoperative hemogram-related parameters to distinguish renal cell carcinoma from benign kidney masses: HERR score

Preoperative hemogram-related parameters to distinguish renal cell carcinoma from benign kidney masses: HERR score

Neutrophil-Lymphocyte Ratio is Valuable in Predicting the Pathology Result in the Patients with Renal Mass > 4 cm Prior to the Partial Nephrectomy

Role of 18F-FDG-PET/CT in Combination With Neutrophil–Lymphocyte Ratio in the Diagnosis of Upper Urinary Tract Lesion: Can We Accurately Predict Malignant Tumor?

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