Kim Kyungmi, Yu Jihion, Park Jun-Young, Baek Sungwoon, Hwang Jai-Hyun, Choi Woo-Jong, Kim Young-Kug
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
J Pers Med. 2021 Sep 23;11(10):947. doi: 10.3390/jpm11100947.
Many studies have investigated the prognostic significance of peripheral blood parameters-including lymphocyte-to-monocyte ratio (LMR)-in several cancers in recent decades. We evaluated the prognostic factors for five-year tumor recurrence after the transurethral resection of a bladder tumor (TURBT). In total, 151 patients with non-muscle invasive bladder tumors who underwent TURBT under spinal anesthesia were selected for this retrospective analysis. The time to tumor recurrence was determined by the number of days from surgery until there was a pathological confirmation of tumor recurrence. The preoperative and postoperative laboratory values were defined as results within one month prior to and one month after TURBT. Univariate and multivariate Cox regression analyses were performed. Seventy-one patients (47.0%) developed recurrent bladder tumors within five years after the first TURBT surgery. The multivariate Cox regression analysis revealed that preoperative LMR (hazard ratio, 0.839; 95% confidence interval, 0.739-0.952; = 0.006) and multiple tumor sites (hazard ratio, 2.072; 95% confidence interval, 1.243-3.453; = 0.005) were independent recurrence predictors in patients with recurrent bladder tumors within five years after the TURBT. A low preoperative LMR is an important predictor for the recurrence of a bladder tumor during a five-year follow-up period after surgery.
近几十年来,许多研究调查了外周血参数(包括淋巴细胞与单核细胞比率(LMR))在几种癌症中的预后意义。我们评估了经尿道膀胱肿瘤切除术(TURBT)后五年肿瘤复发的预后因素。本回顾性分析共纳入了151例在脊髓麻醉下接受TURBT的非肌层浸润性膀胱肿瘤患者。肿瘤复发时间由手术至病理证实肿瘤复发的天数确定。术前和术后实验室检查值定义为TURBT前1个月内和术后1个月内的检查结果。进行了单因素和多因素Cox回归分析。71例患者(47.0%)在首次TURBT手术后五年内出现复发性膀胱肿瘤。多因素Cox回归分析显示,术前LMR(风险比,0.839;95%置信区间,0.739 - 0.952;P = 0.006)和多个肿瘤部位(风险比,2.072;95%置信区间,1.243 - 3.453;P = 0.005)是TURBT后五年内复发性膀胱肿瘤患者独立的复发预测因素。术前低LMR是术后五年随访期间膀胱肿瘤复发的重要预测因素。