Sudoł Damian, Widz Damian, Mitura Przemysław, Płaza Paweł, Godzisz Michał, Kuliniec Iga, Yadlos Andriy, Cabanek Michał, Bar Marek, Bar Krzysztof
Department of Urology and Oncological Urology, Medical University of Lublin, Lublin, Poland.
Cent European J Urol. 2022;75(1):41-46. doi: 10.5173/ceju.2022.0273. Epub 2022 Jan 20.
Neutrophil-to-lymphocyte ratio (NLR) has proven to be promising as a prognostic factor in many malignancies. We investigated the prognostic significance of NLR in patients undergoing radical cystectomy (RC) for bladder cancer (BC).
We retrospectively evaluated the data of 134 consecutive patients with BC who underwent RC between 2011 and 2017 at a single center. Overall survival (OS) was assessed using the Kaplan-Meier method and compared between NLR subpopulations using the log-rank test. Univariate and multivariate Cox proportional hazard models were used to identify the variables affecting OS.
At a median follow-up of 2.2 years, high NLR (>2.7) correlated with worse a survival outcome (p = 0.0345 in log-rank test), higher tumor stage (p = 0.0047), and higher frequency of positive lymph nodes (p = 0.0285). The univariate model showed that a high NLR (p = 0.038528), advanced pathological tumor stage (p = 0.000763), lymph node involvement (p = 0.013384), a high grade of cancer (p = 0.015611), lymphovascular invasion (LVI) (p = 0.001530), positive margins (p = 0.000890) and ureterocutaneostomy as urinary diversion (p = 0.038854) had a negative impact on OS. Tumor extending beyond the submucosa (>pT1) (hazard ratio 2.161, confidence interval 1058-4411, p = 0.0345) and lymphatic infiltration (hazard ratio 1.599, confidence interval 1028-2482, p = 0.037) have been recognized as independent risk factors of poor prognosis in multivariate Cox regression analysis.
In our cohort, an elevated NLR is associated with worse OS and adverse histopathological findings. Consequently, the NLR is an easily acquired biomarker, which may be useful in pretreatment patient risk stratification.
中性粒细胞与淋巴细胞比值（NLR）已被证明在许多恶性肿瘤中作为预后因素具有前景。我们研究了NLR在接受膀胱癌（BC）根治性膀胱切除术（RC）患者中的预后意义。
我们回顾性评估了2011年至2017年间在单一中心连续接受RC的134例BC患者的数据。使用Kaplan-Meier方法评估总生存期（OS），并使用对数秩检验比较NLR亚组之间的生存期。使用单变量和多变量Cox比例风险模型来识别影响OS的变量。
在中位随访2.2年时，高NLR（>2.7）与较差的生存结果相关（对数秩检验中p = 0.0345）、更高的肿瘤分期（p = 0.0047）和更高的阳性淋巴结频率（p = 0.0285）。单变量模型显示，高NLR（p = 0.038528）、晚期病理肿瘤分期（p = 0.000763）、淋巴结受累（p = 0.013384）、高癌症分级（p = 0.015611）、淋巴管侵犯（LVI）（p = 0.001530）、切缘阳性（p = 0.000890）和输尿管皮肤造口术作为尿流改道（p = 0.038854）对OS有负面影响。在多变量Cox回归分析中，肿瘤侵犯超过黏膜下层（>pT1）（风险比2.161，置信区间1.058 - 4.411，p = 0.0345）和淋巴浸润（风险比1.599，置信区间1.028 - 2.482，p = 0.037）已被确认为预后不良的独立危险因素。
在我们的队列中，升高的NLR与较差的OS和不良组织病理学结果相关。因此，NLR是一种易于获取的生物标志物，可能有助于术前患者风险分层。
