Preoperative Serum Cystatin C as an Independent Prognostic Factor for Survival in Patients with Renal Cell Carcinoma.

Autor:	Ma H; School of Public Health, Shanxi Medical University, Taiyuan 030001, China.; Grand Hospital of Shuozhou, Shuozhou 036000, China.; Department of Urology, The First Hospital of Shanxi Medical University, No. 85, JieFang South Road, Yingze District, Taiyuan 030001, China., Wang P; School of Public Health, Shanxi Medical University, Taiyuan 030001, China., Hou Z; Academy of Medical Sciences, Shanxi Medical University, Taiyuan 030001, China., Zhou H; First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, China., Lv D; First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, China., Cui F; Assisted Reproductive Center, Taiyuan Hospital of Peking University First Hospital, Taiyuan 030032, Shanxi, China., Shuang W; School of Public Health, Shanxi Medical University, Taiyuan 030001, China.; First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, China.; Department of Urology, The First Hospital of Shanxi Medical University, No. 85, JieFang South Road, Yingze District, Taiyuan 030001, China.
Jazyk:	angličtina
Zdroj:	Journal of Cancer [J Cancer] 2024 Sep 23; Vol. 15 (18), pp. 5978-5985. Date of Electronic Publication: 2024 Sep 23 (Print Publication: 2024).
DOI:	10.7150/jca.97711
Abstrakt:	Purpose: This study aims to evaluate the prognostic significance of preoperative serum cystatin C (Cys-C) in patients with renal cell carcinoma (RCC). Methods: We analyzed clinicopathological data and follow-up information of 624 RCC patients who underwent partial or radical nephrectomy at our institution. The optimal cutoff value of Cys-C was determined using X-tile software. Survival outcomes, including overall survival (OS) and cancer-specific survival (CSS), were evaluated using the Kaplan-Meier method and log-rank test. To avoid overfitting and collinearity, we used LASSO-based multivariable Cox regression analysis to identify independent predictors of OS and CSS. The predictive accuracy of the established model, including preoperative serum Cys-C, was evaluated using the time-dependent receiver operating characteristic (ROC) curves and the area under the curve (AUC). Results: The median follow-up period was 40 months. The optimal cutoff value of preoperative serum Cys-C levels was 0.95 mg/L. Compared with the low Cys-C group, patients in the high Cys-C group had significantly shorter OS and CSS. Multivariable Cox regression analysis indicated that elevated preoperative serum Cys-C level was an independent adverse predictor for RCC patients post-nephrectomy. After adjusting for all covariates, high preoperative serum Cys-C level was associated with worse OS (hazard ratio [HR]: 2.254; 95% confidence interval [CI]: 1.144, 4.439; P = 0.019) and CSS (HR: 3.621; 95% CI: 1.386, 9.456; P = 0.009). Time-dependent ROC analysis demonstrated that our model, including preoperative serum Cys-C, performed well in predicting accuracy of survival. Conclusions: Preoperative serum Cys-C level is an effective prognostic indicator for OS and CSS in RCC patients undergoing nephrectomy. Competing Interests: Competing Interests: The authors have declared that no competing interest exists. (© The author(s).)
Databáze:	MEDLINE
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