膀胱癌全切术患者术前中性粒细胞-淋巴细胞比率对生存结局的预测分析  

Predictive analysis of preoperative neutrophil-to-lymphocyte ratio on survival outcome in patients with bladder cancer after radical cystectomy

作　　者：李明东 钟鑫 汪朗锟 豆鹏 林天海[1] 张朋[1] LI Ming-dong;ZHONG Xin;WANG Lang-kun;DOU Peng;LIN Tian-hai;ZHANG Peng(Department of Urology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川大学华西医院泌尿外科,四川成都610041

出　　处：《川北医学院学报》2023年第9期1197-1201,1240,共6页Journal of North Sichuan Medical College

基　　金：四川省重点研发项目(No.2023YFS0315)。

摘　　要：目的:探讨接受根治性膀胱切除术(RC)的膀胱癌患者术前中性粒细胞-淋巴细胞比率(NLR)对术后生存结局的预测价值。方法:选取接受RC术式的482例膀胱癌患者作为研究对象,根据术前NLR值是否≥3.89,将患者分为高NLR组(A组,NLR≥3.89)和低NLR组(B组,NLR<3.89)。采用Kaplan-Meier生存分析、单因素和多因素法分析术前NLR值与患者临床特征、病理特征及生存结局的相关性,并比较两组人群的总生存期(OS)及无复发生存期(RFS)。结果:在44个月的中期随访中,A组共计患者120例(24.9%),相较于B组,高龄及男性患者占比更高、晚期肿瘤(pT≥pT3)占比更高、淋巴血管侵犯率更高(P<0.05)。Kaplan-Meier曲线提示高NLR患者的总生存期(OS)和无复发生存期(RFS)较差(P<0.05)。而Cox回归分析则提示高NLR是不良OS的独立预测因子,RFS在多因素分析中无统计学差异(P>0.05)。结论:术前高NLR人群总生存期(OS)更短,高NLR合并淋巴血管侵犯和分期(pT≥pT3)等因素与不良生存结局关联显著。Objective:To explore the predictive value of the preoperative neutrophil-lymphocyte ratio(NLR)for postoperative survival outcomes in bladder cancer patients undergoing radical cystectomy(RC).Methods:482 patients with bladder cancer who received RC surgery were selected.According to whether the preoperative NLR value was greater than 3.89,patients were divided into high NLR group(group A,preoperative NLR greater than 3.89)and low NLR group(group B,preoperative NLR not greater than 3.89).Kaplan-Meier survival analysis,single-factor and multi-factor analysis were used to evaluate the potential correlation between the preoperative NLR value and the patient's clinical/pathological characteristics and survival outcome.On this basis,the overall survival(OS)and recurrence-free survival(RFS)of the two groups were compared between the two groups.Results:At 44 months of interim follow-up,there were a total of 120 patients in group A(24.9%).Compared with group B,the proportion of elderly and male patients was higher,the proportion of advanced tumors(pT≥pT3)was higher,and the rate of lymphatic vascular invasion was higher.Kaplan-Meier curves suggested poor OS and RFS in patients with high NLR.Cox regression analysis suggested that high NLR was an independent predictor of poor OS,while RFS was not statistically significant in multivariate analysis(P>0.05).Conclusion:Patients with high preoperative NLR have shorter OS,and those with high NLR combined with lymphatic vascular invasion and stage(pT≥pT3)are more significantly associated with adverse survival outcomes.

关 键 词：中性粒细胞与淋巴细胞比 根治性膀胱切除术 膀胱癌 预测 预后 影响因素 

分 类 号：R737.14[医药卫生—肿瘤]