Abstract
Introduction: Hematological biomarkers are potential cost-effective tools to gauge systemic inflammation. The cut off values of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have not been standardized in renal cell carcinoma (RCC). The utility of hemoglobin-to-platelet ratio (HPR) has not been thoroughly explored.
Objectives: This study determined the predictive value of NLR, PLR and HPR in the grading and staging of RCC.
Patients and Methods: In this cross-sectional study, the clinicopathological data with NLR, PLR and HPR of 122 RCC cases were analysed retrospectively. Receiver operating characteristic (ROC) curve analysis for each hematological parameter was achieved with respect to the WHO/ISUP (World Health Organization/ International Society of Urological Pathology) grade and T-stage. Univariate and subsequently multivariate analyses were performed. The odds ratio was also calculated.
Results: There was a statistically significant association between the NLR and high grade (P=0.001), high T-stage (P< 0.001), PLR and high grade (P=0.044), high T-stage (P=0.023), HPR and low grade (P=0.005), and low T-stage (P=0.007). Multivariate analysis revealed that high NLR, low HPR, lymphovascular invasion and large tumor size were independent predictors of high grade and high T-stage.
Conclusion: A high preoperative NLR, PLR and low HPR are modest but statistically significant predictors of high WHO/ISUP grade and high pathological T-stage in RCC.