术前中性粒细胞淋巴细胞比值与淋巴细胞单核细胞比值评估非肌层浸润性膀胱癌预后的临床价值

Preoperative neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio predict the prognosis of patients with non-muscle invasive bladder cancer

目的探讨术前中性粒细胞淋巴细胞比值(NLR)与淋巴细胞单核细胞比值(LMR)作为接受经尿道膀胱肿瘤电切术的非肌层浸润性膀胱癌(NMIBC)患者预后评估方法的价值。方法对2011年9月至2017年1月新疆医科大学附属第一医院行经尿道膀胱肿瘤电切术(TURBT)且新诊断为非肌层浸润性膀胱癌的270例患者资料进行回顾性分析。NLR和LMR是通过在TURBT前确定且完整的血常规检测结果计算而来,患者据此分为低NLR组(<2.4,172例)和高NLR组(≥2.4,98例)以及低LMR组(<4,98例)和高LMR组(≥4,172例)。用Kaplan-Meier法绘制各临床因素无复发生存曲线,并用Log-rank检验比较各组内的生存曲线;用Cox多因素分析影响非肌层浸润性膀胱癌预后的独立危险因素。结果 NLR与肿瘤数量、病理分级、肿瘤T分期、复发、进展有关(P<0.05);LMR与性别、年龄有关(P<0.05)。单因素分析结果提示NLR、肿瘤数量、肿瘤大小、病理分级、肿瘤T分期与患者的无复发生存时间有关(P<0.05)。多因素分析提示NLR、肿瘤数量、病理分级、肿瘤T分期是影响肿瘤复发的因素。结论术前NLR是影响非肌层浸润性膀胱癌患者术后无复发生存时间的独立危险因素,可以作为判断预后的一项指标。高NLR的非肌层浸润性膀胱癌患者复发率较低NLR的更高。

Objective To explore the value of preoperative neutrophil-lymphocyte ratio(NLR)and lymphocyte-monocyte ratio(LMR)in predicting the prognosis of patients with non-muscle invasive bladder cancer(NMIBC).Methods Clinical data of NMIBC patients treated with transurethral resection of bladder tumor(TURBT)were retrospectively analyzed.According to the preoperative NLR and LMR,the patients were divided into 4 groups:low NLR group(<2.4,n=172),high NLR group(≥2.4,n=98),low LMR group(<4,n=98)and high LMR group(≥4,n=172).The recurrence-free survival curves were made with Kaplan-Meier method,and compared with log-rank test.The independent risk factors influencing the prognosis of patients were analyzed with Cox multivariate analysis.Results NLR was related to tumor number,pathological grade,T stage,recurrence and progression(P<0.05).LMR was related to gender and age.The results of univariate analysis indicated that NLR,tumor number,tumor size,pathological grade and T stage were related to the non-recurrence survival(P<0.05).Multivariate analysis indicated that NLR,tumor number,pathological grade and T stage were the factors influencing tumor recurrence.Conclusion Preoperative NLR is an independent risk factor influencing postoperative recurrence-free survival of NMIBC patients,which can be used as a prognostic indicator.Patients with high NLR has higher recurrence rate than patients with low NLR.