绝对嗜碱性粒细胞计数与接受经尿道膀胱肿瘤切除术 (TURBT) 后卡介苗灌注治疗的高级别 T1 膀胱癌患者复发时间相关。
Absolute basophil count is associated with time to recurrence in patients with high-grade T1 bladder cancer receiving bacillus Calmette-Guérin after transurethral resection of the bladder tumor.
机构信息
Division of Urology, European Institute of Oncology, via Ripamonti 435, Milan, Italy.
Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy.
出版信息
World J Urol. 2020 Jan;38(1):143-150. doi: 10.1007/s00345-019-02754-2. Epub 2019 Apr 16.
BACKGROUND
Basophils, eosinophils and monocytes may be involved in BCG-induced immune responses and be associated with outcomes of bladder cancer patients receiving intravesical BCG. Our objective was to explore the association of baseline counts of basophils, eosinophils and monocytes with outcomes of patients with high-grade T1 bladder cancer receiving a standard course of intravesical BCG.
METHODS
We retrospectively reviewed medical records of patients with primary T1 HG/G3 bladder cancer. After re-TURBT, patients were treated with a 6-week course of intravesical BCG induction followed by intravesical BCG every week for 3 weeks given at 3, 6, 12, 18, 24, 30 and 36 months from initiation of therapy The analysis of potential risk factors for recurrence, muscle invasion and cancer-specific and overall survival was performed using univariable Cox regression models. Those factors that presented, at univariate analysis, an association with the event at a liberal p < 0.1, have been selected for the development of a multivariable model.
RESULTS
A total of 1045 patients with primary T1 HG/G3 were included. A total of 678 (64.9%) recurrences, 303 (29.0%) progressions and 150 (14.3%) deaths were observed during follow-up. Multivariate analysis showed that logarithmic transformation of basophils count was associated with a 30% increment in the hazard of recurrence per unit increase of logarithmic basophils count (HR 1.30; 95% confidence interval 1.09-1.54; p = 0.0026). Basophil count modeled by quartiles was also significantly associated with time to recurrence [second vs. lower quartile HR 1.42 (1.12-1.79); p = 0.003, third vs. lower quartile HR 1.26 (1.01-1.57); p = 0.041; upper vs. lower quartile HR 1.36 (1.1-1.68); p = 0.005]. The limitations of a retrospective study are applicable.
CONCLUSION
Baseline basophil count may predict recurrence in BCG-treated HG/G3 T1 bladder cancer patients. External validation is warranted.
背景
嗜碱性粒细胞、嗜酸性粒细胞和单核细胞可能参与卡介苗诱导的免疫反应，并与接受卡介苗膀胱内治疗的膀胱癌患者的结局相关。我们的目的是探讨基线嗜碱性粒细胞、嗜酸性粒细胞和单核细胞计数与接受标准卡介苗膀胱内治疗的高级别 T1 膀胱癌患者结局的关系。
方法
我们回顾性分析了原发性 T1HG/G3 膀胱癌患者的病历。在再次经尿道膀胱肿瘤切除术（re-TURBT）后，患者接受 6 周卡介苗诱导治疗，然后在治疗开始后 3、6、12、18、24、30 和 36 个月时每周进行卡介苗膀胱内治疗 3 周。使用单变量 Cox 回归模型分析复发、肌肉浸润以及癌症特异性和总体生存率的潜在危险因素。在单变量分析中，与事件相关且 p<0.1 的因素被选择用于多变量模型的建立。
结果
共纳入 1045 例原发性 T1HG/G3 患者。在随访期间，共观察到 678 例（64.9%）复发、303 例（29.0%）进展和 150 例（14.3%）死亡。多变量分析显示，对数嗜碱性粒细胞计数每增加 1 个单位，复发的风险增加 30%（风险比 1.30；95%置信区间 1.09-1.54；p=0.0026）。按四分位数建模的嗜碱性粒细胞计数也与复发时间显著相关[第二四分位数与最低四分位数相比，风险比 1.42（1.12-1.79）；p=0.003；第三四分位数与最低四分位数相比，风险比 1.26（1.01-1.57）；p=0.041；最高四分位数与最低四分位数相比，风险比 1.36（1.1-1.68）；p=0.005]。
结论
基线嗜碱性粒细胞计数可能预测卡介苗治疗的高级别 T1 膀胱癌患者的复发。需要进行外部验证。
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