Yoshida Takashi, Kinoshita Hidefumi, Yoshida Kenji, Mishima Takao, Yanishi Masaaki, Komai Yoshihiro, Sugi Motohiko, Murota Takashi, Kawa Gen, Matsuda Tadashi
Department of Urology and Andrology, Kori Hospital, Kansai Medical University, Osaka.
Department of Urology and Andrology, Kansai Medical University Hospital, Osaka
Jpn J Clin Oncol. 2016 Dec;46(12):1162-1167. doi: 10.1093/jjco/hyw129. Epub 2016 Sep 2.
To assess the prognostic value of perioperative changes in the neutrophil-lymphocyte ratio in patients with bladder cancer undergoing radical cystectomy.
We performed a retrospective analysis of 323 patients who had undergone radical cystectomy at our institutions. Overall survival was assessed with the Kaplan-Meier method and Cox regression analysis.
Preoperative and postoperative neutrophil-lymphocyte ratios were significantly correlated with overall survival (both P = 0.0001). Changes in perioperative neutrophil-lymphocyte ratio stratified the patients into two groups, designated favorable- and poor-risk groups, with significantly different 5-year overall survival rates (75.1% and 41.4%, respectively; P < 0.0001). Multivariate Cox regression analyses showed that the perioperative change in neutrophil-lymphocyte ratio was an independent prognostic factor for overall survival (hazard ratio 2.56, 95% confidence interval 1.75-3.73; P < 0.001). Moreover, a decrease in neutrophil-lymphocyte ratio after adjuvant chemotherapy was associated with favorable overall survival in patients with high postoperative neutrophil-lymphocyte ratio (P < 0.001), indicating that neutrophil-lymphocyte ratio may be a predictive factor for the efficacy of adjuvant chemotherapy.
Perioperative changes in neutrophil-lymphocyte ratio are significantly associated with overall survival in patients with bladder cancer undergoing radical cystectomy. Follow-up of the neutrophil-lymphocyte ratio change may be useful for the clinical management of patients after surgery.
评估根治性膀胱切除术患者围手术期中性粒细胞与淋巴细胞比值变化的预后价值。
我们对在我院接受根治性膀胱切除术的323例患者进行了回顾性分析。采用Kaplan-Meier法和Cox回归分析评估总生存期。
术前和术后中性粒细胞与淋巴细胞比值均与总生存期显著相关（P均=0.0001）。围手术期中性粒细胞与淋巴细胞比值的变化将患者分为两组，即低危组和高危组，5年总生存率有显著差异（分别为75.1%和41.4%；P<0.0001）。多因素Cox回归分析显示，围手术期中性粒细胞与淋巴细胞比值的变化是总生存期的独立预后因素（风险比2.56，95%置信区间1.75-3.73；P<0.001）。此外，辅助化疗后中性粒细胞与淋巴细胞比值降低与术后中性粒细胞与淋巴细胞比值高的患者总生存期良好相关（P<0.001），表明中性粒细胞与淋巴细胞比值可能是辅助化疗疗效的预测因素。
根治性膀胱切除术患者围手术期中性粒细胞与淋巴细胞比值的变化与总生存期显著相关。对中性粒细胞与淋巴细胞比值变化进行随访可能有助于术后患者的临床管理。
