Preoperative lymphocyte-monocyte ratio ameliorates the accuracy of differential diagnosis in non-metastatic infiltrative renal masses

Jang Hee Han, Young Eun Yoon, Sook Young Kim, Young In Cho, Koon Ho Rha, Young Deuk Choi, Woong Kyu Han

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Distinguishing infiltrative renal cell carcinoma (RCC) from transitional cell carcinoma (TCC) is a challenging issue due to their radiologic similarities. We evaluated systemic inflammatory biomarkers as parameters for distinguishing tumor types. Materials and Methods: A computerized search of medical records from November 2005 to October 2015 identified 116 patients with infiltrative renal masses who were difficult to diagnose confirmatively in radiological study. We investigated the diagnostic efficacy among these patients with their preoperative absolute neutrophil counts (ANC), absolute lymphocyte counts (ALC), absolute monocyte counts (AMC), neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). Results: The infiltrative RCC group demonstrated significantly lower ALC {1449/μL (1140–1896), median [interquartile range (IQR)]} than the TCC group [1860/μL (1433–2342), p=0.016]. LMR [median (IQR)] also was lower in the infiltrative RCC group [2.98 (2.32–4.14) vs. TCC group 4.10 (2.86–6.09); p=0.011]. In subgroup analysis, non-metastatic infiltrative RCC showed lower ALC and LMR and higher NLR than non-metastatic TCC. Within non-metastatic infiltrative renal masses, multivariate logistic regression analysis revealed that younger patient age and lower LMR were associated with infiltrative RCC [odds ratios (OR) 0.874, p=0.024 and OR 0.461, p=0.048, respectively]. Receiver operating characteristic curve analysis showed that younger age and lower LMR were highly predictive of non-metastatic RCC (area under the curve=0.919, p<0.001). Conclusion: Age and LMR were significantly different between patients with infiltrative renal mass. These are potential markers for distinguishing between infiltrative RCC and TCC without metastasis.

Original languageEnglish
Pages (from-to)388-394
Number of pages7
JournalYonsei medical journal
Volume58
Issue number2
DOIs
Publication statusPublished - 2017 Mar

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Renal Cell Carcinoma
Monocytes
Transitional Cell Carcinoma
Differential Diagnosis
Lymphocytes
Kidney
Lymphocyte Count
Neutrophils
Computerized Medical Records Systems
Odds Ratio
ROC Curve
Area Under Curve
Biomarkers
Logistic Models
Regression Analysis
Neoplasm Metastasis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Preoperative lymphocyte-monocyte ratio ameliorates the accuracy of differential diagnosis in non-metastatic infiltrative renal masses",
abstract = "Purpose: Distinguishing infiltrative renal cell carcinoma (RCC) from transitional cell carcinoma (TCC) is a challenging issue due to their radiologic similarities. We evaluated systemic inflammatory biomarkers as parameters for distinguishing tumor types. Materials and Methods: A computerized search of medical records from November 2005 to October 2015 identified 116 patients with infiltrative renal masses who were difficult to diagnose confirmatively in radiological study. We investigated the diagnostic efficacy among these patients with their preoperative absolute neutrophil counts (ANC), absolute lymphocyte counts (ALC), absolute monocyte counts (AMC), neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). Results: The infiltrative RCC group demonstrated significantly lower ALC {1449/μL (1140–1896), median [interquartile range (IQR)]} than the TCC group [1860/μL (1433–2342), p=0.016]. LMR [median (IQR)] also was lower in the infiltrative RCC group [2.98 (2.32–4.14) vs. TCC group 4.10 (2.86–6.09); p=0.011]. In subgroup analysis, non-metastatic infiltrative RCC showed lower ALC and LMR and higher NLR than non-metastatic TCC. Within non-metastatic infiltrative renal masses, multivariate logistic regression analysis revealed that younger patient age and lower LMR were associated with infiltrative RCC [odds ratios (OR) 0.874, p=0.024 and OR 0.461, p=0.048, respectively]. Receiver operating characteristic curve analysis showed that younger age and lower LMR were highly predictive of non-metastatic RCC (area under the curve=0.919, p<0.001). Conclusion: Age and LMR were significantly different between patients with infiltrative renal mass. These are potential markers for distinguishing between infiltrative RCC and TCC without metastasis.",
author = "Han, {Jang Hee} and Yoon, {Young Eun} and Kim, {Sook Young} and Cho, {Young In} and Rha, {Koon Ho} and Choi, {Young Deuk} and Han, {Woong Kyu}",
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Preoperative lymphocyte-monocyte ratio ameliorates the accuracy of differential diagnosis in non-metastatic infiltrative renal masses. / Han, Jang Hee; Yoon, Young Eun; Kim, Sook Young; Cho, Young In; Rha, Koon Ho; Choi, Young Deuk; Han, Woong Kyu.

In: Yonsei medical journal, Vol. 58, No. 2, 03.2017, p. 388-394.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preoperative lymphocyte-monocyte ratio ameliorates the accuracy of differential diagnosis in non-metastatic infiltrative renal masses

AU - Han, Jang Hee

AU - Yoon, Young Eun

AU - Kim, Sook Young

AU - Cho, Young In

AU - Rha, Koon Ho

AU - Choi, Young Deuk

AU - Han, Woong Kyu

PY - 2017/3

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N2 - Purpose: Distinguishing infiltrative renal cell carcinoma (RCC) from transitional cell carcinoma (TCC) is a challenging issue due to their radiologic similarities. We evaluated systemic inflammatory biomarkers as parameters for distinguishing tumor types. Materials and Methods: A computerized search of medical records from November 2005 to October 2015 identified 116 patients with infiltrative renal masses who were difficult to diagnose confirmatively in radiological study. We investigated the diagnostic efficacy among these patients with their preoperative absolute neutrophil counts (ANC), absolute lymphocyte counts (ALC), absolute monocyte counts (AMC), neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). Results: The infiltrative RCC group demonstrated significantly lower ALC {1449/μL (1140–1896), median [interquartile range (IQR)]} than the TCC group [1860/μL (1433–2342), p=0.016]. LMR [median (IQR)] also was lower in the infiltrative RCC group [2.98 (2.32–4.14) vs. TCC group 4.10 (2.86–6.09); p=0.011]. In subgroup analysis, non-metastatic infiltrative RCC showed lower ALC and LMR and higher NLR than non-metastatic TCC. Within non-metastatic infiltrative renal masses, multivariate logistic regression analysis revealed that younger patient age and lower LMR were associated with infiltrative RCC [odds ratios (OR) 0.874, p=0.024 and OR 0.461, p=0.048, respectively]. Receiver operating characteristic curve analysis showed that younger age and lower LMR were highly predictive of non-metastatic RCC (area under the curve=0.919, p<0.001). Conclusion: Age and LMR were significantly different between patients with infiltrative renal mass. These are potential markers for distinguishing between infiltrative RCC and TCC without metastasis.

AB - Purpose: Distinguishing infiltrative renal cell carcinoma (RCC) from transitional cell carcinoma (TCC) is a challenging issue due to their radiologic similarities. We evaluated systemic inflammatory biomarkers as parameters for distinguishing tumor types. Materials and Methods: A computerized search of medical records from November 2005 to October 2015 identified 116 patients with infiltrative renal masses who were difficult to diagnose confirmatively in radiological study. We investigated the diagnostic efficacy among these patients with their preoperative absolute neutrophil counts (ANC), absolute lymphocyte counts (ALC), absolute monocyte counts (AMC), neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). Results: The infiltrative RCC group demonstrated significantly lower ALC {1449/μL (1140–1896), median [interquartile range (IQR)]} than the TCC group [1860/μL (1433–2342), p=0.016]. LMR [median (IQR)] also was lower in the infiltrative RCC group [2.98 (2.32–4.14) vs. TCC group 4.10 (2.86–6.09); p=0.011]. In subgroup analysis, non-metastatic infiltrative RCC showed lower ALC and LMR and higher NLR than non-metastatic TCC. Within non-metastatic infiltrative renal masses, multivariate logistic regression analysis revealed that younger patient age and lower LMR were associated with infiltrative RCC [odds ratios (OR) 0.874, p=0.024 and OR 0.461, p=0.048, respectively]. Receiver operating characteristic curve analysis showed that younger age and lower LMR were highly predictive of non-metastatic RCC (area under the curve=0.919, p<0.001). Conclusion: Age and LMR were significantly different between patients with infiltrative renal mass. These are potential markers for distinguishing between infiltrative RCC and TCC without metastasis.

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