Kaczmarek Krystian, Małkiewicz Bartosz, Gurwin Adam, Krawczyk Wiktor Mateusz, Skonieczna-Żydecka Karolina, Lemiński Artur
Department of General and Oncological Urology, Independent Provincial Public Integrated Hospital, Arkońska 4, 71-455 Szczecin, Poland.
Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland.
J Clin Med. 2024 Mar 28;13(7):1953. doi: 10.3390/jcm13071953.
Neutrophil-to-lymphocyte ratio (NLR), a widely assessed biomarker in most common diseases, is typically evaluated before treatment initiation. However, data on NLR in the post-treatment setting is limited. Therefore, we assessed the NLR calculated after neoadjuvant chemotherapy (NAC) initiation in patients with bladder cancer (BC). We hypothesised that changes in blood cells after NAC could be a marker of tumour response and long-term survival. Our study included 214 patients who underwent NAC followed by radical cystectomy (RC) in two urological departments, wherein post-NAC NLR was used to categorize patients into the low (NLR ≤ 1.75) and high (NLR > 1.75) groups. Logistic regression analysis indicated that a post-NAC NLR ≥ 1.75 is a good biomarker for pathologic response (odds ratio (OR), 0.045; <0.001), emphasizing its ability to predict patient survival. The HRs for overall survival and cancer-specific survival were 2.387 ( = 0.048) and 2.342 ( < 0.001), respectively. We believe that post-NAC NLR can be used for patient stratification after NAC. Consequently, the post-NAC NLR may serve as a guide for the decision-making process regarding RC versus bladder-preserving strategies.
中性粒细胞与淋巴细胞比值（NLR）是大多数常见疾病中广泛评估的生物标志物，通常在治疗开始前进行评估。然而，治疗后环境中NLR的数据有限。因此，我们评估了膀胱癌（BC）患者新辅助化疗（NAC）开始后计算的NLR。我们假设NAC后血细胞的变化可能是肿瘤反应和长期生存的标志物。我们的研究纳入了214例在两个泌尿外科接受NAC后行根治性膀胱切除术（RC）的患者，其中NAC后的NLR用于将患者分为低（NLR≤1.75）和高（NLR>1.75）两组。逻辑回归分析表明，NAC后NLR≥1.75是病理反应的良好生物标志物（比值比（OR），0.045；<0.001），强调了其预测患者生存的能力。总生存和癌症特异性生存的HR分别为2.387（=0.048）和2.342（<0.001）。我们认为NAC后的NLR可用于NAC后患者的分层。因此，NAC后的NLR可作为关于RC与膀胱保留策略决策过程的指导。
