Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
Investig Clin Urol. 2021 Nov;62(6):641-649. doi: 10.4111/icu.20210278.
Many studies identified that the preoperative neutrophil-to-lymphocyte ratio (PNLR) was associated with patient prognosis in non-muscle-invasive bladder cancer (NMIBC). We hypothesized that PNLR could be prognostic in patients with histological variants of NMIBC (VH-NMIBC).
This retrospective study included patients with VH-NMIBC admitted at our center between January 2009 and May 2019. The best cut-off value of NLR was measured by the receiver operating characteristic curve and Youden index. The Kaplan-Meier method and Cox proportional hazard regression models were employed to evaluate the association between PNLR and disease prognosis, including recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS).
A total of 243 patients with VH-NMIBC were enrolled in our study. According to the Kaplan-Meier method results, patients with PNLR ≥2.2 were associated with poor RFS (p<0.001), PFS (p<0.001), CSS (p<0.001), and OS (p<0.001). Multivariable analyses indicated that PNLR ≥ 2.2 was an independent prognostic factor of RFS (hazard ratio [HR], 2.11; 95% confidence interval [CI, 1.57-1.83; p<0.001), PFS (HR, 2.34; 95% CI, 1.70-3.21; p<0.001), CCS (HR, 2.87; 95% CI, 1.96-4.18; p< 0.001), and OS (HR, 2.83; 95% CI, 1.96-4.07; p<0.001).
This study identified that PNLR ≥2.2 was usually associated with a poor prognosis for patients with VH-NMIBC.
许多研究表明，术前中性粒细胞与淋巴细胞比值（PNLR）与非肌层浸润性膀胱癌（NMIBC）患者的预后相关。我们假设 PNLR 可以预测组织学变异型 NMIBC（VH-NMIBC）患者的预后。
本回顾性研究纳入了 2009 年 1 月至 2019 年 5 月期间在我院就诊的 VH-NMIBC 患者。通过接收者操作特征曲线和 Youden 指数来测量 NLR 的最佳截断值。采用 Kaplan-Meier 法和 Cox 比例风险回归模型评估 PNLR 与疾病预后（包括无复发生存（RFS）、无进展生存（PFS）、癌症特异性生存（CSS）和总生存（OS））之间的关系。
共纳入 243 例 VH-NMIBC 患者。根据 Kaplan-Meier 法的结果，PNLR≥2.2 的患者与较差的 RFS（p<0.001）、PFS（p<0.001）、CSS（p<0.001）和 OS（p<0.001）相关。多变量分析表明，PNLR≥2.2 是 RFS（危险比 [HR]，2.11；95%置信区间 [CI]，1.57-1.83；p<0.001）、PFS（HR，2.34；95% CI，1.70-3.21；p<0.001）、CSS（HR，2.87；95% CI，1.96-4.18；p<0.001）和 OS（HR，2.83；95% CI，1.96-4.07；p<0.001）的独立预后因素。
本研究表明，PNLR≥2.2 通常与 VH-NMIBC 患者的不良预后相关。
