Wang Chengbo, Jin Wenjun, Ma Xiaodong, Dong Zhilong
The Department of Urology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu, China.
The Department of Urology, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China.
Front Oncol. 2023 Jan 11;12:1101830. doi: 10.3389/fonc.2022.1101830. eCollection 2022.
The inflammatory response plays a potential role in postoperative recurrence in patients with non-muscular invasive bladder cancer (NMIBC). We aimed to investigate whether platelet-to-lymphocyte ratio (PLR), mean platelet volume to lymphocyte ratio (MPVLR), and the systemic immune-inflammatory index (SII) have prognostic values in NMIBC treated with conventional intravesical chemotherapy or intravesical Chemohyperthermia (CHT) and the differences between them.
A retrospective cohort study was conducted on 222 patients with NMIBC treated with Intravesical Chemotherapy or Intravesical CHT between January 2016 and December 2020. Within a week before surgery, PLR, MPVLR, and SII were determined based on routine blood settling. The optimal cutoff value of each index was determined using the receiver operating characteristic curve, and various groups were categorized accordingly. The factors influencing the prognosis of NMIBC patients receiving various treatments were investigated using the Kaplan- Meier survival curve and the Cox regression model.
69 cases (46.3%) in the gemcitabine (GEM) group had tumor recurrence and 19 (12.8%) of them progressed to muscle-invasive bladder cancer (MIBC) or got metastasis, while 19 cases (26.0%) in the CHT group recurred and 2 (2.7%) progressed. Elevated PLR, MPVLR, and SII were associated with higher recurrence rates in the GEM group. Meanwhile, PLR and MPVLR were the independent risk factors. While in the CHT group, high PLR and SII were related to postoperative recurrence and none of them were independent risk factors.
The preoperative clinical inflammatory indexes PLR, SII, and MPVLR have certain predictive value for the postoperative recurrence-free survival (RFS) in NMIBC patients treated with intravesical chemotherapy while PLR and SII can predict the prognosis of NMIBC patients treated with intravesical CHT, which indicates that intravesical CHT may stop tumor recurrence by influencing the effect of mean platelet volume on tumor growth through some unknown mechanisms.
炎症反应在非肌层浸润性膀胱癌（NMIBC）患者术后复发中发挥潜在作用。我们旨在研究血小板与淋巴细胞比值（PLR）、平均血小板体积与淋巴细胞比值（MPVLR）和全身免疫炎症指数（SII）在接受传统膀胱内化疗或膀胱内热化疗（CHT）的NMIBC患者中是否具有预后价值以及它们之间的差异。
对2016年1月至2020年12月期间接受膀胱内化疗或膀胱内热化疗的222例NMIBC患者进行回顾性队列研究。在手术前一周内，根据常规血液沉降测定PLR、MPVLR和SII。使用受试者工作特征曲线确定每个指标的最佳截断值，并据此对各个组进行分类。使用Kaplan-Meier生存曲线和Cox回归模型研究影响接受各种治疗的NMIBC患者预后的因素。
吉西他滨（GEM）组69例（46.3%）出现肿瘤复发，其中19例（12.8%）进展为肌层浸润性膀胱癌（MIBC）或发生转移，而CHT组19例（26.0%）复发，2例（2.7%）进展。GEM组中PLR、MPVLR和SII升高与较高的复发率相关。同时，PLR和MPVLR是独立危险因素。而在CHT组中，高PLR和SII与术后复发有关，且它们均不是独立危险因素。
术前临床炎症指标PLR、SII和MPVLR对接受膀胱内化疗的NMIBC患者术后无复发生存期（RFS）具有一定的预测价值，而PLR和SII可预测接受膀胱内热化疗的NMIBC患者的预后，这表明膀胱内热化疗可能通过一些未知机制影响平均血小板体积对肿瘤生长的作用来阻止肿瘤复发。
