基于术前中性粒细胞与淋巴细胞比值的膀胱癌侵袭预测性
Bladder cancer invasion predictability based on preoperative neutrophil-lymphocyte ratio.
作者信息
Kaynar Mehmet, Yıldırım Mehmet Erol, Badem Hüseyin, Caviş Mücahit, Tekinarslan Erdem, Istanbulluoğlu Mustafa Okan, Karataş Ömer Faruk, Çimentepe Ersin
机构信息
Department of Urology, Faculty of Medicine, Selcuk University, Konya, Turkey,
出版信息
Tumour Biol. 2014 Jul;35(7):6601-5. doi: 10.1007/s13277-014-1889-x. Epub 2014 Apr 3.
An increased pretreatment neutrophil-lymphocyte ratio (NLR) is associated with poor prognosis in colorectal, gastric, and ovarian cancer; malignant mesothelioma; and renal cell carcinoma. The present study aims to define the predictive value of preoperative peripheral blood count NLR in non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive disease (MIBC) patients. There were in total 291 patients, 241 males and 50 females. Out of these, 156 male and 36 female patients were in the NMIBC group and 85 male and 14 female patients in the MIBC group. In the NMIBC group, 172 patients had low-grade and 20 high-grade papillary urothelial carcinoma. The mean age of the patients in the NMIBC group was 64 ± 13, ranging from 27 to 97. The mean age of the patients in MIBC group was 70.5 ± 10, ranging from 27 to 95. A statistically significant relation between patient ages and tumor invasiveness was determined (p = 0.023, 95 % confidence interval (CI) 63.3-66.7). The mean tumor size of the NMIBC group was 2.1 ± 1.09 (cm) (range 0.5-8), and of MIBC group 3.6 ± 1.5 (cm) (range 0.8-9). There was a statistically significant relation between the tumor size and invasiveness (p = 0.002, 95 % CI 2.8-4.4). In the NIMBC group, 149 (77.6 %) of them have NLR ≤ 2.5 and 43 (22.4 %) have NLR > 2.5. Also, in MIBC, 67 (67.7 %) of them have NLR ≤ 2.5 and 32 (32.3 %) have NLR > 2.5. The mean NLR in the NMIBC group was 2.4 ± 0.1 (range 0.08-6.49, 95 % CI 1.52-2.71) and in the MIBC 2.9 ± 0.2 (range 0.08-16.72, 95 % CI 1.67-2.97). In terms of NLR, there was a statistically significant difference between the NMIBC and MIBC groups (p = 0.028). Platelet-lymphocyte ratio (PLR) of the two groups was also analyzed. The PLR of the NMIBC group was 12.8 ± 15.1 (range 3.38-19.1) and of the MIBC 13.6 ± 8.78 (range 0.18-63), yet there was not any statistically significant difference (p = 0.810, 95 % CI 11.4-14.8) (Table 1). The correlation tests revealed a positive correlation between the age (r = 0.144, p = 0.024), tumor size (r = 0.193, p = 0.02), and tumor invasiveness NLR (r = 0.138, p = 0.031). NLR can be used to determine tumor invasiveness as a cost-effective, common, and simple biomarker in bladder cancer (BC).
术前中性粒细胞与淋巴细胞比值（NLR）升高与结直肠癌、胃癌、卵巢癌、恶性间皮瘤及肾细胞癌的预后不良相关。本研究旨在确定术前外周血细胞计数NLR在非肌层浸润性膀胱癌（NMIBC）和肌层浸润性膀胱癌（MIBC）患者中的预测价值。研究共纳入291例患者，其中男性241例，女性50例。其中，NMIBC组有男性156例、女性36例，MIBC组有男性85例、女性14例。在NMIBC组中，172例患者为低级别乳头状尿路上皮癌，20例为高级别乳头状尿路上皮癌。NMIBC组患者的平均年龄为64±13岁，范围为27至97岁。MIBC组患者的平均年龄为70.5±10岁，范围为27至95岁。确定患者年龄与肿瘤浸润性之间存在统计学显著关系（p = 0.023，95%置信区间（CI）63.3 - 66.7）。NMIBC组的平均肿瘤大小为2.1±1.09（cm）（范围0.5 - 8），MIBC组为3.6±1.5（cm）（范围0.8 - 9）。肿瘤大小与浸润性之间存在统计学显著关系（p = 0.002，95% CI 2.8 - 4.4）。在NIMBC组中，149例（77.6%）患者的NLR≤2.5，43例（22.4%）患者的NLR>2.5。同样，在MIBC组中，67例（67.7%）患者的NLR≤2.5，32例（32.3%）患者的NLR>2.5。NMIBC组的平均NLR为2.4±0.1（范围0.08 - 6.49，95% CI 1.52 - 2.71），MIBC组为2.9±0.2（范围0.08 - 16.72，95% CI 1.67 - 2.97）。就NLR而言，NMIBC组和MIBC组之间存在统计学显著差异（p = 0.028）。还分析了两组的血小板与淋巴细胞比值（PLR）。NMIBC组的PLR为12.8±15.1（范围3.38 - 19.1），MIBC组为13.6±8.78（范围0.18 - 63），但无统计学显著差异（p = 0.810，95% CI 11.4 - 14.8）（表1）。相关性检验显示年龄（r = 0.144，p = 0.024）、肿瘤大小（r = 0.193，p = 0.02）与肿瘤浸润性NLR之间呈正相关（r = 0.138，p = 0.031）。NLR可作为一种经济有效、常见且简单的生物标志物用于确定膀胱癌（BC）的肿瘤浸润性。
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