非肌层浸润性膀胱癌患者外周血NLR、中性粒细胞与血红蛋白乘积与术后预后的关系  

Correlation between peripheral blood NLR,neutrophil-hemoglobin product and postoperative prognosis in patients with non-muscle invasive bladder cancer

作　　者：檀结 毕满华 郭志文 蒋方 TAN Jie;BI Manhua;GUO Zhiwen;JIANG Fang(Department of Urology,Anqing First People′s Hospital Affiliated to Anhui Medical University,Anqing,Anhui 246000,China)

机构地区：[1]安徽医科大学附属安庆第一人民医院泌尿外科,安徽安庆246000

出　　处：《检验医学与临床》2024年第10期1472-1477,共6页Laboratory Medicine and Clinic

摘　　要：目的观察非肌层浸润性膀胱癌患者术前中性粒细胞/淋巴细胞(NLR)、中性粒细胞与血红蛋白乘积表达情况,并分析两项指标对术后复发的预测价值。方法选择2020年7月至2022年3月拟于该院接受经尿道膀胱肿瘤电切术的80例非肌层浸润性膀胱癌患者为研究对象,采集术前、术后12个月外周血,采用全自动五分类血细胞分析仪检测中性粒细胞绝对值(Neu#)、淋巴细胞绝对值(Lym#)、血红蛋白水平,并计算NLR、中性粒细胞与血红蛋白乘积。术后随访12个月,根据是否复发将患者分为复发组、未复发组,比较两组术前基础资料、术前实验室指标,采用多因素Logistic回归分析筛选非肌层浸润性膀胱癌术后复发的影响因素,绘制受试者工作特征(ROC)曲线分析术前NLR、中性粒细胞与血红蛋白乘积及二者联合对非肌层浸润性膀胱癌术后复发的预测价值。结果术前非肌层浸润性膀胱癌患者NLR、中性粒细胞与血红蛋白乘积、Neu#高于术后12个月,Lym#、血红蛋白水平低于术后12个月,差异有统计学意义(P<0.05);随访12个月,80例非肌层浸润性膀胱癌患者术后复发19例(23.75%),纳入复发组,其余61例纳入未复发组;复发组肿瘤数量多发占比、NLR、中性粒细胞与血红蛋白乘积、Neu#高于未复发组,Lym#、血红蛋白水平低于未复发组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,肿瘤数量多发[OR:3.117(95%CI:1.134~8.566)]、NLR[OR:1.480(95%CI:1.116~1.963)]、中性粒细胞与血红蛋白乘积[OR:1.003(95%CI:1.001~1.006)]、Neu#[OR:1.606(95%CI:1.151~2.241)]水平升高是非肌层浸润性膀胱癌术后复发的危险因素(P<0.05),Lym#[OR:0.263(95%CI:0.076~0.914)]、血红蛋白[OR:0.932(95%CI:0.880~0.988)]水平升高是非肌层浸润性膀胱癌术后复发的保护因素(P<0.05);ROC曲线分析结果显示,NLR、中性粒细胞与血红蛋白乘积预测非肌层浸润性膀胱癌术后复发的AUC分别为0.809Objective To observe the expression of preoperative neutrophil to lymphocyte ratio(NLR)and neutrophil-hemoglobin product in patients with non-muscle invasive bladder cancer,and to analyze the predictive value of these two indicators for postoperative recurrence.Methods Eighty patients with non-muscle invasive bladder cancer who planned to undergo transurethral resection of bladder tumor in Anqing First People′s Hospital Affiliated to Anhui Medical University from July 2020 to March 2022 were selected as the research objects.Peripheral blood was collected before and 12 months after surgery,neutrophil absolute value(Neu#),lymphocyte absolute value(Lym#),hemoglobin were detected by automatic five classification hematology analyzer,and the NLR,neutrophil-hemoglobin product were calculated.The patients were divided into recurrence group and non-recurrence group according to the presence or absence of recurrence.The preoperative basic data and preoperative laboratory indexes of the two groups were compared,and the multivariate Logistic regression model was established to screen the influencing factors of postoperative recurrence of non-muscle invasive bladder cancer.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of preoperative NLR and neutrophil-hemoglobin product for postoperative recurrence of non-muscle invasive bladder cancer.Results NLR,neutrophil-hemoglobin product,NEU#levels of preoperative patients with non-muscle invasive bladder cancer were significantly higher than those of postoperative 12 months(P<0.05),Lym#and hemoglobin levels were significantly lower than those of postoperative 12 months(P<0.05).Among the 80 patients with non-muscle invasive bladder cancer,19 patients(23.75%)had recurrence after 12 months of follow-up,which were included in the recurrence group,and the remaining 61 patients were enrolled in the non-recurrence group.The proportion of multiple tumors,NLR,neutrophil-hemoglobin product and Neu#in the recurrence group were higher than those in th

关 键 词：非肌层浸润性膀胱癌 复发 中性粒细胞 淋巴细胞 血红蛋白 

分 类 号：R737.14[医药卫生—肿瘤]