High Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Associated With Sarcopenia Risk in Hospitalized Renal Cell Carcinoma Patients.

Qiang Hu,Ming Chen,Junjie Yu,Tiange Wu,Can Wang,Zhipeng Xu,Saisai Chen,Bin Xu,Yueshuang Xu,Weipu Mao,Shuqiu Chen

doi:10.3389/fonc.2021.736640

Abstract

PurposeThis study aimed i) to identify the best cutoff points of neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) that predict sarcopenia and ii) to illustrate the association between sarcopenia risk and NLR or PLR in renal cell carcinoma (RCC) patients undergoing laparoscopic partial or radical nephrectomy.MethodsA total of 343 RCC patients who underwent laparoscopic partial or radical nephrectomy between 2014 and 2019 were enrolled in our study. Sarcopenia was assessed by lumbar skeletal muscle index (SMI). Receiver operating characteristic (ROC) curve was used to identify the best cutoff point of NLR or PLR to predict sarcopenia risk. Univariate and multivariate logistic regression and dose–response analysis curves of restricted cubic spline function were conducted to assess the relationship between sarcopenia and NLR or PLR.ResultsThe best cutoff points of NLR >2.88 or PLR >135.63 were confirmed by the ROC curve to predict sarcopenia risk. Dose–response curves showed that the risk of sarcopenia increased with raising NLR and PLR. Patients with NLR >2.88 or PLR >135.63 had a higher sarcopenia risk than those in the NLR ≤2.8 or PLR ≤135.63 group, respectively. By adjusting for all variables, we found that patients with NLR >2.88 and PLR >135.63 had 149% and 85% higher risk to develop sarcopenia, respectively, than those with NLR ≤2.8 (aOR = 2.49; 95% CI = 1.56–3.98; p < 0.001) or PLR ≤135.63 (aOR = 1.85; 95% CI = 1.16–2.95; p = 0.010).ConclusionIn RCC patients receiving laparoscopic partial or radical nephrectomy, NLR and PLR, which were biomarkers of systemic inflammation, were associated with sarcopenia risk.

Highlights

Renal cell carcinoma (RCC) is a common malignance with a morbidity of 2%–3% in systemic cancers [1]
By adjusting for all variables, we found that patients with NLR >2.88 and PLR >135.63 had 149% and 85% higher risk to develop sarcopenia, respectively, than those with NLR ≤2.8 or PLR ≤135.63
The Receiver operating characteristic (ROC) curve showed that the best cutoff point to define the sarcopenia risk was NLR >2.88 (AUC = 0.611, 95% CI = 0.557– 0.663, p = 0.0004, with sensitivity of 69.9% and specificity of 51.2%) or PLR >135.63 (AUC = 0.602, 95% CI = 0.548–0.654, p = 0.0012, with sensitivity of 58.8% and specificity of 57.5%) (Figure 2)

Summary

Introduction

Renal cell carcinoma (RCC) is a common malignance with a morbidity of 2%–3% in systemic cancers [1]. Clear cell renal cell carcinoma as the most common subtype accounts for 80%–85% of RCC cases. 170,000 patients diagnosed with RCC died in 2018 worldwide, and the mortality is about 2.7% [2]. Patients diagnosed with RCC at an early stage can be effectively treated by radical or partial nephrectomy, resulting in a 5-year survival rate up to 93%. Due to regional and distant metastases, the 5-year survival rate of advanced RCC patients decreases to 67% [3]. Molecular targeted therapy and immunotherapy, with or without cytoreductive surgery, remain the widely used treatments [4], it is still a clinical challenge to prolong the survival of advanced RCC patients

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