术前外周血中性粒细胞与淋巴细胞比值在肌层浸润性膀胱癌预后评估中的价值  

Value of preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after radical resection of bladder cancer for muscle-invasive bladder cancer

作　　者：刘静[1] 韩献成[2] 李春龙[2] 栾志敏[2] 高佃军[2] 刘伟光[2] 

机构地区：[1]山东省潍坊市中医院病理科,261041 [2]潍坊医学院附属医院泌尿外科

出　　处：《中国综合临床》2016年第10期932-935,共4页Clinical Medicine of China

摘　　要：目的：探讨术前外周血中性粒细胞与淋巴细胞比值（ NLR）在肌层浸润性膀胱癌患者预后评估中的价值。方法回顾性分析2006年1月1日至2010年3月1日在潍坊医学院附属医院泌尿外科接受根治性膀胱全切的252例肌层浸润性膀胱癌患者的临床资料，均经术后病理证实。以NLR＝2．7作为临界值，高NLR组（≥2．7）110例，低NLR组（＜2．7）142例，所有患者术前均未接受放化疗。结果高NLR组和低NLR组患者的5年生存率分别为53％和75．2％，差异有统计学意义（ P＝0．005）。单因素分析结果显示：术前NLR（ P＝0．002）、肿瘤大小（ P＝0．035）、T分期（ P＝0．002）、组织学分级（ P＝0．04）、有无肾积水（ P＝0．031）及有无淋巴结转移（ P＝0．003）是患者预后的影响因素。 Cox多因素分析结果显示术前NLR是影响患者预后独立危险因素（ HR：2．586；95％CI：1．256～2．851；P＝0．039）。结论对于接受根治性膀胱全切的肌层浸润性膀胱癌患者，术前外周血NLR≥2．7是患者预后不良的独立危险因素。Objective To investigate the value of preoperative neutrophil-to-lymphocyte ratio（NLR） as a prognostic predictor after radical resection of bladder cancer for muscle-bladder cancer. Methods Two hundred and fifty-two cases consecutive muscle-invasive bladder cancer patients treated with total excision radi-cal bladder at the Rology Surgery Department of Affiliated Hospital of Weifang Medical College from January 2006 to March 2010 were retrospectively analyzed,and all patients were diagnosed bladder cancer by pathological examination. Based on the cut-off value of 2. 7,all the patients were divided into two groups：a low NLR（〈2. 7,n=142） group and a high NLR（≥2. 7,n=110） group. None accepted neoadjuvant therapy. Results The 5-year overall survival rate was 75. 2% in patients of the low NLR group and 53% in the high NLR group,the difference was significant（P=0. 005）. Univariate analysis showed that NLR（P=0. 002）,tumor size（P=0. 035）,T stage （P=0. 0022）,tumor grade（P=0. 04）,hydronep-hrosis or no（P=0. 031）,Lymph node metastasis or no（P=0. 003） were associated with survival. Cox multivariate analysis revealed that NLR was independent risk factors of prognosis（HR：2. 586;95%CI：1. 256-2. 851;P=0. 039）. Conclusion Preoperative NLR≥2. 7 may be a convenient biomarker to predict patients with a poor prognosis after radical cystectomy for muscle-invasive blad-der cancer.

关 键 词：膀胱癌 预后 中性粒细胞 淋巴细胞 

分 类 号：R737.14[医药卫生—肿瘤]