Zhao Ming, Zhang Mingxin, Wang Yonghua, Yang Xuecheng, Teng Xue, Chu Guangdi, Wang Xinsheng, Niu Haitao
Department of Urology, Qingdao 8th People's Hospital, Qingdao, People's Republic of China.
Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.
Onco Targets Ther. 2020 Dec 29;13:13265-13274. doi: 10.2147/OTT.S285098. eCollection 2020.
This study investigated the prognostic value of the preoperative albumin alkaline phosphatase ratio (AAPR) in patients with muscle-invasive bladder cancer after radical cystectomy.
We performed a retrospective, single-center cohort study among patients with muscle-invasive bladder cancer who underwent radical cystectomy and urinary diversion at the Department of Urology Surgery of the Affiliated Hospital of Qingdao University from 2007 to 2015. Cox proportional hazards regression was used to evaluate the relationship between preoperative AAPR and outcomes which include OS and CSS and RFS. Survival analysis was conducted using the Kaplan-Meier method and the log rank test.
In total, 174 patients were followed up for 1-125 months, with a median follow-up of 30 months, 93 survived and 81 patients died. The median serum AAPR level in all patients was 0.62 (range: 0.12-1.67). In multivariate analysis, the preoperative AAPR showed to be associated with overall survival (OS: HR 0.22,95% CI 0.06 to 0.82, P=0.024), cancer-specific survival (CSS: HR 0.12,95% CI 0.02 to 0.63, P=0.013) and recurrence-free survival (RFS: HR 0.15,95% CI 0.03 to 0.82, P=0.029) after adjustment for potential confounders. Kaplan-Meier analysis showed that patients with low AAPR tertiles had shorter OS, CSS and RFS than patients with high AAPR tertiles (OS: P<0.001, CSS: P<0.001, RFS: P<0.001). The relationship between AARP and OS, CSS and RFS was linear.
Preoperative AAPR may be a potentially valuable prognostic marker in patients who underwent radical cystectomy for muscle-invasive bladder cancer.
本研究探讨术前白蛋白碱性磷酸酶比值（AAPR）在根治性膀胱切除术后肌层浸润性膀胱癌患者中的预后价值。
我们对2007年至2015年在青岛大学附属医院泌尿外科接受根治性膀胱切除术及尿流改道的肌层浸润性膀胱癌患者进行了一项回顾性单中心队列研究。采用Cox比例风险回归评估术前AAPR与包括总生存期（OS）、癌症特异性生存期（CSS）和无复发生存期（RFS）在内的预后之间的关系。使用Kaplan-Meier方法和对数秩检验进行生存分析。
总共174例患者随访1至125个月，中位随访时间为30个月，93例存活，81例死亡。所有患者血清AAPR水平的中位数为0.62（范围：0.12 - 1.67）。在多变量分析中，校正潜在混杂因素后，术前AAPR显示与总生存期（OS：风险比[HR] 0.22，95%置信区间[CI] 0.06至0.82，P = 0.024）、癌症特异性生存期（CSS：HR 0.12，95% CI 0.02至0.63，P = 0.013）和无复发生存期（RFS：HR 0.15，95% CI 0.03至0.82，P = 0.029）相关。Kaplan-Meier分析显示，AAPR三分位数低的患者的OS、CSS和RFS比AAPR三分位数高的患者短（OS：P < 0.001，CSS：P < 0.001，RFS：P < 0.001）。AARP与OS、CSS和RFS之间的关系呈线性。
术前AAPR可能是接受根治性膀胱切除术的肌层浸润性膀胱癌患者潜在有价值的预后标志物。
