Bizzarri Francesco Pio, Campetella Marco, Russo Pierluigi, Palermo Giuseppe, Moosavi Seyed Koosha, Rossi Francesco, D'Amico Lorenzo, Cretì Antonio, Gavi Filippo, Panio Enrico, Presutti Simona, Bellavia Fabrizio, Ragonese Mauro, Ciccarese Chiara, Iacovelli Roberto, Sighinolfi Maria Chiara, Racioppi Marco, Sacco Emilio, Rocco Bernardo
Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy.
Department of Urology, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, Italy.
Cancers (Basel). 2025 Jun 28;17(13):2189. doi: 10.3390/cancers17132189.
Given the increasing interest in the predictive role of inflammation in oncology, we aimed to assess the association between inflammatory factors (IFs) and the histopathological characteristics of bladder cancer (BC). Our objective was to correlate some of these IFs with BC progression and recurrence, identifying possible new diagnostic tools. : We retrospectively analyzed 285 patients (79.8% male, 20.4% female; median age 73) who underwent transurethral resection of the bladder (TURB) between January 2016 and January 2022. The preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), systemic inflammation response index (SIRI), and standard clinical variables were collected one month before TURB and evaluated as predictors of recurrence and progression. Patients were stratified using the Youden Index and ROC analysis. Cox regression models were applied to identify independent predictors. : High-grade tumors were present in 74.6% of cases, and 34% were recurrent. Carcinoma in situ was found in 5%. After 72 months, 53% underwent radical cystectomy, and 13.7% died within 5 years. The optimal cutoffs were PLR 139, SIRI 1.12, PIV 248.49, NLR 2, SII 327. Smoking, primary MIBC, age, and lymph node status were significantly associated with recurrence. Elevated PLR correlated with recurrence and T2 progression ( = 0.004). Higher SIRI, PIV, and PLR levels were significantly associated with lymphovascular invasion and nodal metastasis ( < 0.05). PLR was linked to recurrence in tumors ≥ 3 cm post-BCG ( = 0.004); high SIRI predicted recurrence within 48 months ( = 0.05). : High PLR and SIRI levels were associated with recurrence. Our findings support the emerging role of IFs in predicting BC outcomes and suggest their potential inclusion in future prognostic models.
鉴于炎症在肿瘤学中的预测作用日益受到关注，我们旨在评估炎症因子（IFs）与膀胱癌（BC）组织病理学特征之间的关联。我们的目标是将其中一些IFs与BC的进展和复发相关联，以确定可能的新诊断工具。我们回顾性分析了2016年1月至2022年1月期间接受经尿道膀胱肿瘤切除术（TURB）的285例患者（男性占79.8%，女性占20.4%；中位年龄73岁）。在TURB前一个月收集术前中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、全身免疫炎症指数（SII）、全免疫炎症值（PIV）、全身炎症反应指数（SIRI）以及标准临床变量，并将其作为复发和进展的预测指标进行评估。使用约登指数和ROC分析对患者进行分层。应用Cox回归模型确定独立预测因素。74.6%的病例为高级别肿瘤，34%复发。原位癌占5%。72个月后，53%的患者接受了根治性膀胱切除术，13.7%的患者在5年内死亡。最佳临界值为PLR 139、SIRI 1.12、PIV 248.49、NLR 2、SII 327。吸烟、原发性肌层浸润性膀胱癌、年龄和淋巴结状态与复发显著相关。PLR升高与复发和T2期进展相关（P = 0.004）。较高的SIRI、PIV和PLR水平与淋巴管浸润和淋巴结转移显著相关（P < 0.05）。PLR与卡介苗治疗后肿瘤≥3 cm的复发相关（P = 0.004）；高SIRI预测48个月内复发（P = 0.05）。高PLR和SIRI水平与复发相关。我们的研究结果支持IFs在预测BC预后方面的新作用，并表明它们可能被纳入未来的预后模型。
