Pre-treatment Delta Neutrophil Index as a Predictive Factor in Renal Cell Carcinoma

To determine the diagnostic value of the pre-treatment delta neutrophil index (DNI) before treatment in patients with renal cell carcinoma (RCC) and to compare this marker with other routine inflammation markers, such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR).

Descriptive study.

Department of Urology, Kahramanmaras Sutcu Imam University, Turkey, from February 2017 to January 2020.

Data of patients who underwent radical nephrectomy for RCC, were evaluated. For comparison, healthy individuals were included in the study as a control group. Demographic data, such as age, gender, routine laboratory tests, DNI, NLR, and PLR levels of the groups were recorded and compared.

There were 73 patients in the RCC group and 71 healthy individuals in the control group. DNI, NLR and PLR levels were significantly higher in the RCC group (p <0.001, each). DNI and NLR were significantly higher in patients with advanced stage (T3-T4) and high grade (G3-G4). In univariate logistic regression analysis hemoglobin (p=0.023), neutrophil (p<0.001), lymphocyte (p=0.009), platelet (p<0.001), DNI (p<0.001), NLR (p<0.001) and PLR (p<0.001) were identified as predictors for RCC. In multivariate logistic regression analysis, DNI and NLR (p<0.001, each) were found to be the predictors of RCC. Cut-off values were 0.45% for DNI, 1.80 for NLR, and 130.09 for PLR.

DNI is a new inflammatory marker, which is included in complete blood count parameters; and does not require any additional calculation, unlike NLR and PLR. It can be used in the prediction of RCC. Key Words: Renal cell carcinoma, Delta neutrophil index, Neutrophil-lymphocyte ratio, Platelet-lymphocyte ratio.