膀胱尿路上皮癌患者外周血中性粒细胞/淋巴细胞比值及相关病理特征的关系研究

The correlation of neutrophil to lymphocyte ratio and the pathological features of patients with bladder urothelial carcinoma

目的探讨外周血中性粒细胞/淋巴细胞比值(NLR)与膀胱尿路上皮癌患者病理特征的关系及其临床意义。方法选取2015年1月至2017年10月在该院确诊的91例膀胱尿路上皮癌患者作为研究对象,记录外周血中性粒细胞计数、淋巴细胞计数并计算NLR,用单因素分析法分析相关病理指标(如肿瘤部位、肿瘤大小、病理类型、浸润程度、组织分化程度、TNM分期等)与NLR的关系,用受试者工作特征曲线(ROC曲线)确定NLR的临界值,并用多因素Logistic回归分析法探索NLR的独立影响因素。结果不同肿瘤大小、肿瘤数目、病理分级、组织分化程度、浸润程度和是否发生淋巴结转移的患者NLR水平,差异均有统计学意义(P<0.05)。是否发生淋巴结转移、浸润程度、组织分化程度是NLR的独立影响因素,有淋巴结转移、浸润度为T3和T4、高度分化的肿瘤患者NLR更高。结论 NLR与肿瘤淋巴结转移状况、浸润程度和组织分化程度间有显著相关性,以NLR作为膀胱尿路上皮癌发生、发展的预测指标具有一定的临床意义。

Objective To explore the relationship between neutrophil to lymphocyte ratio(NLR)and the pathological features of patients with bladder urothelial carcinoma and its clinical significance.Methods Totally 91 patients with bladder and urinary tract cancer diagnosed in our hospital from January 2015 to October 2017 were selected as the study subjects.Numbers of neutrophils and lymphocytes in peripheral blood were recorded and NLR was calculated.Univariate analysis was used to analyze the relationship between NLR and related pathological indicators(such as tumor location,size,pathological type,infiltration degree,tissue differentiation degree,TNM stage,etc.).The critical value of NLR was determined by ROC curve.Multivariate logistic regression analysis was used to explore the independent influencing factors of NLR.Results There were significant differences in NLR levels among patients with different tumor size,number of tumors,pathological grade,degree of differentiation,degree of invasion and lymph node metastasis(P<0.05).The occurrence of lymph nodes metastasis,infiltration degree and differentiation degree were independent influencing factors of NLR.The patients with lymph node metastasis,infiltration degree(T3,T4)and highly differentiated tumors had higher NLR.Conclusion NLR is significantly correlated with lymph node metastasis,infiltration and differentiation of bladder and urinary tract cancer.It has certain clinical significance to use NLR as a predictor of the occurrence and development of bladder and urinary tract cancer.