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术前淋巴细胞与单核细胞比值及血小板与淋巴细胞比值作为接受根治性膀胱切除术的膀胱癌患者总生存的预测指标

Preoperative lymphocyte-monocyte and platelet-lymphocyte ratios as predictors of overall survival in patients with bladder cancer undergoing radical cystectomy.

作者信息

Zhang Gui-Ming, Zhu Yao, Luo Lei, Wan Fang-Ning, Zhu Yi-Ping, Sun Li-Jiang, Ye Ding-Wei

机构信息

Department of Urology, Fudan University Shanghai Cancer Center, No. 270, Dongan Rd., Shanghai, 200023, People's Republic of China.

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

出版信息

Tumour Biol. 2015 Nov;36(11):8537-43. doi: 10.1007/s13277-015-3613-x. Epub 2015 Jun 2.

DOI:10.1007/s13277-015-3613-x
PMID:26032095
Abstract

Although pretreatment neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and platelet-lymphocyte ratio (PLR) are reportedly associated with clinical outcomes of many cancers, their roles in patients with bladder cancer (BCa) who undergo radical cystectomy (RC) have not been widely investigated. We analyzed relationships between preoperative NLR, LMR, PLR, and overall survival (OS) in 124 BCa patients undergoing RC. OS curves were drawn using the Kaplan-Meier method and evaluated using the log-rank test. Relationships between OS and potential confounding variables were determined using Cox's proportional hazard regression model. Decreased LMR was associated with shorter OS (P = 0.012); OS in the low PLR group was significantly longer than that in the high PLR group (P = 0.029), and NLR was not significantly associated with oncological outcomes. However, after adjusting for confounding variables, patients in the high-LMR group indicated >30% decreased mortality than the low-LMR group (hazard ratio 0.674; 95% confidence interval 0.412-0.890; P = 0.003), and PLR was not an independent predictor of OS. Our results show that preoperative LMR is a better prognostic factor in BCa patients undergoing RC, compared with NLR and PLR.

摘要

尽管据报道,治疗前中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)以及血小板与淋巴细胞比值(PLR)与多种癌症的临床结局相关,但其在接受根治性膀胱切除术(RC)的膀胱癌(BCa)患者中的作用尚未得到广泛研究。我们分析了124例接受RC的BCa患者术前NLR、LMR、PLR与总生存期(OS)之间的关系。采用Kaplan-Meier法绘制OS曲线,并使用对数秩检验进行评估。使用Cox比例风险回归模型确定OS与潜在混杂变量之间的关系。LMR降低与较短的OS相关(P = 0.012);低PLR组的OS明显长于高PLR组(P = 0.029),且NLR与肿瘤学结局无显著相关性。然而,在对混杂变量进行校正后,高LMR组患者的死亡率比低LMR组降低了>30%(风险比0.674;95%置信区间0.412 - 0.890;P = 0.003),且PLR不是OS的独立预测因素。我们的结果表明,与NLR和PLR相比,术前LMR是接受RC的BCa患者更好的预后因素。

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