中性粒细胞/淋巴细胞比值在肌层浸润性膀胱癌预后评估中的价值  

Preoperative neutrophil-lymphocyte ratio predicts clinical outcome in patients undergoing radical cystectomy for muscle-invasive bladder cancer

作　　者：白云金 蒲春晓[1] 韩平[1] 员海超[1] 王小明[1] 唐寅[1] 李金洪[1] 魏强[1] 

机构地区：[1]四川大学华西医院泌尿外科,四川成都610041

出　　处：《现代泌尿外科杂志》2015年第1期15-17,共3页Journal of Modern Urology

基　　金：国家自然科学基金(No.81270841);四川省科技厅科技支撑计划(No.2013SZ0034)

摘　　要：目的 探讨术前外周血中性粒细胞与淋巴细胞比值（NLR）是否可以作为肌层浸润性膀胱癌（MIBC）患者术后的预后评价指标.方法 回顾性分析2008年1月至2011年12月行膀胱癌根治术的214例MIBC患者的临床资料,根据患者术前外周血NLR大小分为低NLR组（NLR＜3,92例）和高NLR组（NLR≥3,122例）,比较两组患者的5年生存率并进行预后危险因素分析.结果 低NLR组和高NLR组MIBC患者5年生存率分别为70.9％和55.8％ （P＜0.01）.单因素分析显示,术前NLR、吸烟史、病理T分期、肿瘤分级、围手术期输血、淋巴结转移、淋巴结密度及切缘阳性与MIBC患者预后有关（P＜0-05）;Cox回归分析证实,NLR是影响MIBC患者预后的独立危险因素（HR=2.142,95％CI：1.212～3.786,P＜0.01）.结论 术前NLR是影响MIBC患者术后生存时间的独立危险因素,可作为MIBC患者的预后指标.Objective To assess the value of preoperative neutrophil-lymphocyte ratio （NLR） for prognosis in patients with muscle-invasive bladder cancer （MIBC） after radical cystectomy （RC）. Methods Clinical data of 214 patients with MI- BC undergoing RC during Jan. 2008 to Dec. 2011 were retrospectively reviewed. According to preoperative NLR, patients were divided into the low N LR group（NLR≥ 3, n = 92） and the high NLR group（NLR≥3, n = 122）. The overall 5-year survival rates of two groups were compared. Prognostic value of the preoperative clinical and laboratory parameters were evaluated by univariate and multivariate Cox proportional hazard model analyses. Results The overall 5-year survival rates of the low and high NLR groups were 70.9%0 and 55.8%, respectively （P〈0.01）. In univariate analysis, NLR, smoking, pT stage, tumor grade, transfusion, lymph node metastasis, lymph node density and positive radial margin were significantly associated with poor prognosis. Moreover, on multivariate analysis, increased preoperative NLR was independent risk factor of prognosis （hazard ratio[HR] =2. 142,95% CI： 1. 212 -- 3. 786, P〈0.01）. Conclusions Elevated preoperative NLR among patients undergoing RC is associated with significantly increased risk for overall survival rates. Preoperative serum NLR may be a prognostic marker in patients with MIBC.

关 键 词：膀胱癌 中性粒细胞/淋巴细胞比值 预后 

分 类 号：R697[医药卫生—泌尿科学]