Background
Methods
Patients
Clinical data extraction
Patients follow-up
Statistical analysis
Results
Patient demographics and outcomes
Characteristics | Cases (n = 570) | Percentage (%) |
---|---|---|
Age (years) (Mean ± SD) | 51.43 ± 13.52 | |
BMI (Mean ± SD) | 23.57 ± 3.59 | |
Gender | ||
Male | 382 | 67.00 |
Female | 188 | 33.00 |
Pathological types | ||
Clear cell carcinoma | 451 | 79.10 |
Papillary carcinoma | 41 | 7.20 |
Others | 78 | 13.70 |
Fuhrman-grade | ||
I | 119 | 20.90 |
II | 249 | 43.70 |
III | 60 | 10.50 |
IV | 7 | 1.20 |
Unknown | 135 | 23.70 |
pTNM stage | ||
I | 397 | 69.60 |
II | 85 | 14.90 |
III | 59 | 10.40 |
IV | 29 | 5.10 |
pT status | ||
T1 | 407 | 71.40 |
T2 | 94 | 16.50 |
T3+ T4 | 69 | 12.10 |
pN status | ||
N0 | 535 | 93.90 |
N1 | 35 | 6.10 |
pM status | ||
M0 | 550 | 96.50 |
M1 | 20 | 3.50 |
Urine protein | ||
No | 460 | 80.70 |
Yes | 28 | 4.90 |
Unknown | 82 | 14.40 |
ALP | ||
Normal | 525 | 92.10 |
Elevated | 45 | 7.90 |
LDH | ||
Normal | 468 | 82.10 |
Elevated | 102 | 17.90 |
CRE | ||
Normal | 546 | 95.80 |
Elevated | 24 | 4.20 |
UA | ||
Normal | 461 | 80.90 |
Elevated | 109 | 19.10 |
Total protein | ||
Normal | 503 | 88.20 |
Elevated | 67 | 11.80 |
Serum globulin | ||
Normal | 360 | 63.20 |
Elevated | 210 | 36.80 |
NLR | ||
< 1.85 | 242 | 42.50 |
≥ 1.85 | 328 | 57.50 |
PLR | ||
< 153 | 418 | 73.30 |
≥ 153 | 152 | 26.70 |
CRP/Alb | ||
< 0.08 | 393 | 68.90 |
≥ 0.08 | 177 | 31.10 |
The relationship of serum CRP and Alb with OS
The optimal cut-off value of inflammation-based factors by the ROC analysis
The clinicopathological characteristics and the preoperative CRP/Alb ratio
Characteristics | CRP/Alb < 0.08 (n = 393) | CRP/Alb ≥ 0.08 (n = 177) |
P value |
---|---|---|---|
Age (years) | 48.71 ± 12.98 | 55.25 ± 13.92 | <0.001a
|
BMI | 23.65 ± 3.37 | 23.41 ± 4.02 | 0.290a
|
Gender | 0.219b
| ||
Male | 257 (65.40%) | 125 (70.60%) | |
Female | 136 (34.60%) | 52 (29.40%) | |
Pathological types | 0.315b
| ||
Clear cell carcinoma | 308 (81.20%) | 43 (80.80%) | |
Papillary carcinoma | 26 (3.80%) | 15 (8.50%) | |
Others | 59 (15.00%) | 19 (10.70%) | |
Fuhrman-grade | <0.001b
| ||
I | 92 (23.40%) | 27(15.30%) | |
II | 178(45.30%) | 71(40.10%) | |
III | 31(7.90%) | 29(16.40%) | |
IV | 2(0.50%) | 5(2.80%) | |
Unknown | 90(22.90%) | 45(25.40%) | |
pTNM stage | <0.001b
| ||
I | 313(79.60%) | 84(47.50%) | |
II | 53(13.50%) | 32(18.10%) | |
III | 22(5.60%) | 37(20.90%) | |
IV | 5 (1.30%) | 24(13.60%) | |
pT status | <0.001b
| ||
T1 | 318 (80.90%) | 89 (50.30%) | |
T2 | 54 (13.70%) | 40 (22.60%) | |
T3+ T4 | 21 (5.30%) | 48 (27.10%) | |
pN status | <0.001b
| ||
N0 | 382 (97.20%) | 153 (86.40%) | |
N1 | 11 (2.80%) | 24 (13.60%) | |
pM status | <0.001b
| ||
M0 | 390 (99.20%) | 160 (90.40%) | |
M1 | 3 (0.80%) | 17 (9.60%) | |
Urine protein | 0.188b
| ||
No | 319 (81.20%) | 141 (79.7%) | |
Yes | 15 (3.80%) | 13 (7.3%) | |
Unknown | 59 (15.00%) | 23 (13.00%) | |
ALP | 0.018b
| ||
Normal | 369 (93.90%) | 156 (88.10%) | |
Elevated | 24 (6.10%) | 21 (11.90%) | |
LDH | 0.004b
| ||
Normal | 335 (85.20%) | 133 (75.10%) | |
Elevated | 58 (14.80%) | 44 (24.90%) | |
CRE | 0.001b
| ||
Normal | 384 (97.70%) | 162 (91.50%) | |
Elevated | 9 (2.30%) | 15 (8.50%) | |
UA | 0.468b
| ||
Normal | 321 (81.70%) | 140 (79.10%) | |
Elevated | 72 (18.30%) | 37 (20.90%) | |
Total protein | 0.144b
| ||
Normal | 352 (89.60%) | 151 (85.30%) | |
Elevated | 41 (10.40%) | 26 (14.70%) | |
Serum globulin | |||
Normal | 273 (69.50%) | 87 (49.20%) | <0.001b
|
Elevated | 120 (30.50%) | 90 (50.80%) | |
NLR | <0.001b
| ||
< 1.85 | 205 (52.20%) | 37 (20.90%) | |
≥ 1.85 | 188 (47.80%) | 140 (79.10%) | |
PLR | <0.001b
| ||
< 153 | 324 (82.40%) | 94 (53.10%) | |
≥ 153 | 69 (17.60%) | 83 (46.90%) |
The relationship between the preoperative CRP/Alb ratio and OS in all RCC patients
OS Univariate analysis | OS Multivariate analysis | |||||
---|---|---|---|---|---|---|
Characteristics | 95% CIs | HR |
P value | 95% CIs | HR |
P value |
Age (years) | 1.01 to 1.05 | 1.03 | <0.001a
| 1.01 to 1.05 | 1.03 | <0.001b
|
BMI | 0.82 to 0.93 | 0.87 | <0.001a
| 0.84 to 0.97 | 0.91 | 0.007b
|
Gender | ||||||
Male | 1.00(ref.) | |||||
Female | 0.73 to 1.82 | 1.16 | 0.532a
| |||
Pathological types | ||||||
Clear cell carcinoma | 1.00(ref.) | 1.00(ref.) | ||||
Papillary carcinoma | 1.36 to 4.72 | 2.53 | 0.003a
| 0.67 to 4.39 | 1.72 | 0.258b
|
Others | 0.70 to 2.42 | 1.30 | 0.414a
| 0.64 to 3.99 | 1.60 | 0.312b
|
Fuhrman-grade | ||||||
I | 1.00(ref.) | 1.00(ref.) | ||||
II | 0.68 to 2.82 | 1.39 | 0.365a
| 0.72 to 3.21 | 1.52 | 0.269b
|
III | 1.46 to 7.14 | 3.23 | 0.004a
| 0.57 to 3.09 | 1.33 | 0.507b
|
IV | 1.70 to 22.12 | 6.14 | 0.006a
| 0.43 to 6.08 | 1.62 | 0.474b
|
unknown | 1.25 to 5.19 | 2.55 | 0.010a
| 0.43 to 2.55 | 1.05 | 0.922b
|
pTNM stage | ||||||
I | 1.00(ref.) | |||||
II | 1.27 to 4.85 | 2.48 | 0.008a
| |||
III | 3.51 to 11.40 | 6.33 | <0.001a
| |||
IV | 14.54 to 46.54 | 26.01 | <0.001a
| |||
pT status | ||||||
T1 | 1.00(ref.) | 1.00(ref.) | ||||
T2 | 1.76 to 5.46 | 3.10 | <0.001a
| 1.20 to 3.90 | 2.16 | 0.011b
|
T3+ T4 | 4.72 to 12.92 | 7.81 | <0.001a
| 0.91 to 3.13 | 1.69 | 0.098b
|
pN status | ||||||
N0 | 1.00(ref.) | 1.00(ref.) | ||||
N1 | 6.42 to 17.09 | 10.47 | <0.001a
| 1.91 to 6.85 | 3.62 | <0.001b
|
pM status | ||||||
M0 | 1.00(ref.) | 1.00(ref.) | ||||
M1 | 8.71 to 26.12 | 15.08 | <0.001a
| 1.57 to 6.19 | 3.12 | 0.001b
|
Urine protein | ||||||
No | 1.00(ref.) | |||||
Yes | 0.46 to 2.84 | 1.14 | 0.773a
| |||
Unknown | 0.48 to 1.74 | 0.92 | 0.787a
| |||
ALP | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.61 to 2.63 | 1.27 | 0.527a
| |||
LDH | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.84 to 2.34 | 1.40 | 0.203a
| |||
CRE | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.78 to 4.07 | 1.78 | 0.175a
| |||
UA | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.77 to 4.08 | 1.78 | 0.176a
| |||
Total protein | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.77 to 2.54 | 1.40 | 0.265a
| |||
Serum globulin | ||||||
Normal | 1.00(ref.) | 1.00(ref.) | ||||
Elevated | 1.66 to 4.03 | 2.59 | <0.001a
| 0.84 to2.31 | 1.39 | 0.203b
|
NLR | ||||||
< 1.85 | 1.00(ref.) | 1.00(ref.) | ||||
≥ 1.85 | 3.08 to 11.59 | 5.97 | <0.001a
| 0.97 to 4.32 | 2.05 | 0.060b
|
PLR | ||||||
< 153 | 1.00(ref.) | 1.00(ref.) | ||||
≥ 153 | 3.49 to 8.56 | 5.46 | <0.001a
| 1.43 to 4.07 | 2.42 | <0.001b
|
CRP/Alb | ||||||
< 0.08 | 1.00(ref.) | 1.00(ref.) | ||||
≥ 0.08 | 3.48 to 8.86 | 5.55 | <0.001a
| 1.12 to 3.36 | 1.94 | 0.018b
|
The relationship between the preoperative CRP/Alb ratio and DFS in localized (T1-3 N0/+ M0) RCC patients underwent full resection
DFS Univariate analysis | DFS Multivariate analysis | |||||
---|---|---|---|---|---|---|
Characteristics | 95% CIs | HR |
P value | 95% CIs | HR |
P value |
Age (years) | 1.02 to 1.05 | 1.03 | 0.002a
| 1.01 to 1.06 | 1.03 | <0.001b
|
BMI | 0.79 to 0.93 | 0.86 | <0.001a
| 0.82 to 0.97 | 0.89 | 0.005b
|
Gender | ||||||
Male | 1.00(ref.) | |||||
Female | 0.57 to 1.66 | 0.97 | 0.921a
| |||
Pathological types | ||||||
Clear cell carcinoma | 1.00(ref.) | 1.00(ref.) | ||||
Papillary carcinoma | 1.15 to 4.80 | 2.35 | 0.019a
| 0.62 to 2.99 | 1.47 | 0.431b
|
Others | 0.33 to 1.80 | 0.77 | 0.550a
| 0.32 to 1.91 | 0.78 | 0.587b
|
Fuhrman-grade | ||||||
I | 1.00(ref.) | |||||
II | 0.62 to 2.68 | 1.28 | 0.504a
| |||
III | 1.01 to 5.86 | 2.44 | 0.047a
| |||
IV | 0.97 to 20.24 | 4.99 | 0.055a
| |||
unknown | 0.68 to 3.40 | 1.53 | 0.299a
| |||
pTNM stage | ||||||
I | 1.00(ref.) | |||||
II | 1.33 to 4.84 | 2.54 | 0.005a
| |||
III | 3.54 to 11.08 | 6.26 | <0.001a
| |||
pT status | ||||||
T1 | 1.00(ref.) | 1.00(ref.) | ||||
T2 | 1.57 to 5.03 | 2.81 | <0.001a
| 1.29 to 4.35 | 2.38 | 0.005b
|
T3 | 2.20 to 8.03 | 4.20 | <0.001a
| 0.65 to 2.72 | 1.33 | 0.437b
|
pN status | ||||||
N0 | 1.00(ref.) | 1.00(ref.) | ||||
N1 | 3.72 to 13.73 | 7.15 | <0.001a
| 2.19 to 10.09 | 4.70 | <0.001b
|
Urine protein | ||||||
No | 1.00(ref.) | |||||
Yes | 0.44 to 3.40 | 1.23 | 0.691a
| |||
Unknown | 0.28 to 1.49 | 0.64 | 0.301a
| |||
ALP | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.19 to 2.02 | 0.63 | 0.440a
| |||
LDH | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.84 to 2.69 | 1.51 | 0.168a
| |||
CRE | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.59 to 4.51 | 1.64 | 0.341a
| |||
UA | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.44 to 1.69 | 0.86 | 0.654a
| |||
Total protein | ||||||
Normal | 1.00(ref.) | |||||
Elevated | 0.37 to 1.97 | 0.85 | 0.704a
| |||
Serum globulin | ||||||
Normal | 1.00(ref.) | 1.00(ref.) | ||||
Elevated | 1.26 to 3.40 | 2.07 | 0.004a
| 0.69 to 2.05 | 1.19 | 0.533b
|
NLR | ||||||
< 1.85 | 1.00(ref.) | 1.00(ref.) | ||||
≥ 1.85 | 2.06 to 7.58 | 3.95 | <0.001a
| 0.78 to 3.37 | 1.62 | 0.193b
|
PLR | ||||||
< 153 | 1.00(ref.) | 1.00(ref.) | ||||
≥ 153 | 2.54 to 6.92 | 4.19 | <0.001a
| 1.38 to 4.32 | 2.44 | 0.002b
|
CRP/Alb | ||||||
< 0.08 | 1.00(ref.) | 1.00(ref.) | ||||
≥ 0.08 | 2.54 to 7.02 | 4.22 | <0.001a
| 1.22 to 3.75 | 2.14 | 0.008b
|