淋巴细胞与C反应蛋白比值在膀胱癌根治性膀胱切除患者中的预后价值:一项基于人群的研究
Prognostic Value of Lymphocyte-C-Reactive Protein Ratio in Patients Undergoing Radical Cystectomy for Bladder Cancer: A Population-Based Study.
作者信息
Zhang Houliang, Wang Yidi, Ni Jinliang, Shi Huajuan, Zhang Tao, Zhang Yifan, Guo Jing, Wang Keyi, Mao Weipu, Peng Bo
机构信息
Department of Urology, Shanghai Putuo District People's Hospital, Tongji University, Shanghai, China.
Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
出版信息
Front Oncol. 2021 Oct 28;11:760389. doi: 10.3389/fonc.2021.760389. eCollection 2021.
PURPOSE
This study aimed to assess the prognostic value of the lymphocyte-C-reactive protein ratio (LCR) in patients with bladder cancer (BCa) who underwent radical cystectomy (RC).
MATERIALS AND METHODS
BCa patients between 2009 and 2018 were retrieved from our medical center. The predictive value of LCR on survival of BCa patients was evaluated through the Kaplan-Meier survival and receiver operating characteristic (ROC) curves. The multivariate Cox regression results were used for conducting the nomogram, which were further verified by ROC, decision curve analysis (DCA), and calibration curves. Propensity score matching (PSM) was performed to validate our findings.
RESULTS
A total of 201 BCa patients who received RC were included in this study, with 62 (30.8%) patients in the low LCR group and 139 (69.2%) in the high LCR group. Multivariate analysis results revealed that the high LCR group was significantly related to better prognosis and functioned as a prognostic biomarker for overall survival (OS) [hazard ratio (HR) = 0.41, 95% CI, 0.26-0.66; < 0.001] and disease-free survival (DFS) [HR = 0.40, 95% CI, 0.26-0.66; < 0.001]. The nomogram processed better predictive capability and accuracy than TNM stage from ROC results (AUC = 0.754 . AUC = 0.715), with the confirmation of calibration curves and DCA. The result of PSM confirmed that LCR was significantly correlated with OS and DFS.
CONCLUSION
Our finding demonstrates that LCR is a novel, convenient, and effective predictor that may provide vital assistance for clinical decision and individualized therapy in BCa patients after RC.
目的
本研究旨在评估淋巴细胞 - C反应蛋白比值(LCR)对接受根治性膀胱切除术(RC)的膀胱癌(BCa)患者的预后价值。
材料与方法
从我们的医疗中心检索2009年至2018年期间的BCa患者。通过Kaplan-Meier生存曲线和受试者工作特征(ROC)曲线评估LCR对BCa患者生存的预测价值。多变量Cox回归结果用于构建列线图,并通过ROC、决策曲线分析(DCA)和校准曲线进一步验证。进行倾向评分匹配(PSM)以验证我们的研究结果。
结果
本研究共纳入201例接受RC的BCa患者,低LCR组62例(30.8%),高LCR组139例(69.2%)。多变量分析结果显示,高LCR组与更好的预后显著相关,并且作为总生存(OS)[风险比(HR)=0.41,95%可信区间(CI),0.26 - 0.66;P<0.001]和无病生存(DFS)[HR = 0.40,95% CI, 0.26 - 0.66;P<0.001]的预后生物标志物。根据ROC结果(AUC = 0.754对AUC = 0.715)以及校准曲线和DCA的确认,列线图比TNM分期具有更好的预测能力和准确性。PSM结果证实LCR与OS和DFS显著相关。
结论
我们的研究结果表明,LCR是一种新颖、便捷且有效的预测指标,可以为RC术后BCa患者的临床决策和个体化治疗提供重要帮助。
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