全身免疫炎症指数和C-反应蛋白与白蛋白比值对膀胱癌术后尿路感染风险的预测价值  

Predictive values of systemic immune inflammatory index and the ratio of C-reactive protein to albumin for urinary tract infection risk after bladder cancer surgery

作　　者：刘华颖 雷玉莲 杨天立 秦志强[1] 徐宁[1] LIU Huaying;LEI Yulian;YANG Tianli;QIN Zhiqiang;XU Ning(Department of Urology,Nanjing Hospital Affiliated to Nanjing Medical University/Nanjing First Hospital,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院泌尿外科,南京210004

出　　处：《临床肿瘤学杂志》2024年第12期1205-1210,共6页Chinese Clinical Oncology

摘　　要：目的 探讨全身免疫炎症指数(SII)和C-反应蛋白(CRP)与白蛋白(ALB)比值在膀胱癌患者的表达特征,构建经尿道膀胱肿瘤切除术后尿路感染风险预测体系并分析其临床价值。方法 选取2020年1月至2022年6月于本院泌尿外科因膀胱癌接受经尿道膀胱肿瘤切除术治疗的120例患者为研究对象,依据尿路感染诊断标准分为术后尿路感染组(n=57)和未感染组(n=63)。收集膀胱癌患者的临床资料,采用多因素Logistic回归分析法对影响膀胱癌患者术后尿路感染的危险因素进行分析;受试者工作特征曲线分析SII、CRP/ALB体系对膀胱癌术后尿路感染的预测价值;Pearson相关分析SII、CRP/ALB体系与尿液中膀胱癌相关抗原(BTAA)的相关性;Kaplan-Meier生存曲线分析SII、CRP/ALB体系与膀胱癌患者生存的关系。结果 经尿道膀胱肿瘤切除术后尿路感染组的SII和CRP/ALB水平高于未感染组(t=2.117、2.372,P<0.05);年龄>60岁、术前尿培养阳性以及SII高值和CRP/ALB高值是经尿道膀胱肿瘤切除术后尿路感染的独立风险因素;SII和CRP/ALB联合检测对膀胱癌术后尿路感染评估曲线下面积为0.804,灵敏度、特异度分别为82.46%、80.95%;且SII和CRP/ALB水平与尿液BTAA均呈正相关(r=0.643、0.395,P<0.001);SII和CRP/ALB水平增加,患者生存率降低(χ^(2)=18.601、24.515,P<0.001)。结论 SII和CRP/ALB体系是经尿道膀胱肿瘤切除术后尿路感染评估有价值的生物标记物,可为临床制定膀胱癌术后尿路感染防治策略提供参考依据。Objective To explore the expression characteristics of systemic immune inflammatory index(SII)and the ratio of C-reactive protein(CRP)to albumin(ALB)in patients with bladder cancer,and build a risk prediction system of urinary tract infection after transurethral resection of bladder cancer and analyze its clinical value.Methods From January 2020 to June 2022,120 patients with bladder cancer who received transurethral resection of bladder tumor were selected as the study subjects.They were divided into postoperative urinary tract infection group(n=57)and uninfected group(n=63)according to the diagnostic criteria for urinary tract infections.Clinical data of bladder cancer patients were collected and Logistic regression model was used to analyze the risk factors of postoperative urinary tract infection in bladder cancer patients.The predictive value of SII,CRP/ALB system on urinary tract infection after bladder cancer surgery was analyzed by receiver operating characteristic curve.Pearson correlation analysis was used to investigate the correlation between SII,CRP/ALB systems and bladder tumor-associated antigen(BTAA).Kaplan-Meier survival curve was used to analyze SII,CRP/ALB system and survival of bladder cancer patients.Results The levels of SII and CRP/ALB in the urinary tract infection group after transurethral bladder tumor resection were higher than those in the non-infection group(t=2.117,2.372,P<0.05).Age>60 years old,positive preoperative urine culture,high SII and CRP/ALB values were independent risk factors for urinary tract infections after transurethral bladder tumor resection.The area under the evaluation curve of SII and CRP/ALB for urinary tract infection after bladder cancer surgery was 0.804 with the sensitivity of 82.46%and specificity of 80.95%,respectively.The levels of SII and CRP/ALB were positively correlated with BTAA(r=0.643,0.395,P<0.001).The levels of SII and CRP/ALB increased,and the patient survival rate decreased(x^(2)=18.601,24.515,P<0.001).Conclusion SII and CRP/ALB systems are val

关 键 词：膀胱癌 尿路感染 全身免疫炎症指数 C-反应蛋白与白蛋白比值 预测模型 

分 类 号：R737.13[医药卫生—肿瘤]