肌层浸润性膀胱癌患者在根治性膀胱切除术前的NLR、PLR和LMR与术后预后的关系

Correlation between NLR, PLR and LMR before radical cystectomy and postoperative prognosis in patients with muscle invasive bladder cancer

目的探讨肌层浸润性膀胱癌(MIBC)患者术前中性粒细胞淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)和淋巴细胞单核细胞比值(LMR)与根治性膀胱切除术后预后的关系。方法收集行根治性膀胱切除术的MIBC患者临床资料,并对患者进行随访,采用Cox单因素和多因素回归分析NLR、PLR和LMR与MIBC患者的术后无转移或复发生存率(RFS)和总体生存率(OS)的关系,分别以NLR、PLR、LMR均数为标准分为高值组与低值组,绘制生存曲线,分析NLR、PLR和LMR对MIBC患者预后的预测意义。结果共纳入129例MIBC患者。Cox单因素及多因素回归分析均显示,MIBC患者在根治性膀胱切除术前的NLR、PLR、LMR均与术后RFS、OS有关(P均<0.05)。NLR<2.40组和NLR≥2.40组、PLR<159.3组和PLR≥159.3组、LMR<3.76组和LMR≥3.76组患者生存曲线比较差异均有统计学意义(P均<0.05),其中高NLR组、高PLR组及低LMR组患者的术后RFS、OS较低。结论MIBC患者在根治性膀胱切除术前高NLR、高PLR或低LMR提示预后不良,NLR、PLR和LMR可考虑作为评估MIBC患者预后的生物标志物。

Objective To investigate the relationship between the preoperative neutrophil lymphocyte ratio(NLR),platelet lymphocyte ratio(PLR),lymphocyte monocyte ratio(LMR)and clinical prognosis of patients with muscle invasive bladder cancer(MIBC)after radical cystectomy.Methods Clinical data of MIBC patients undergoing radical cystectomy were collected,and all patients were followed up.Univariate and multivariate Cox regression analyses were conducted to analyze the relationship between NLR,PLR and LMR and the postoperative metastasis-free or recurrence-free survival rate(RFS)and overall survival rate(OS)of MIBC patients.All patients were divided into high- and low-value groups based on the mean NLR,PLR and LMR,respectively.The survival curve was drawn to predict the significance of NLR,PLR and LMR on the clinical prognosis of MIBC patients.Results A total of 129 patients with MIBC were included.Univariate and multivariate Cox regression analyses demonstrated that NLR,PLR and LMR of MIBC before radical cystectomy were all significantly correlated with postoperative RFS and OS(all P<0.05).The survival curves significantly differed between the NLR<2.40 and NLR ≥ 2.40 groups,between the PLR<159.3 and PLR ≥ 159.3 groups,and between the LMR<3.76 and LMR ≥ 3.76 groups(all P<0.05).The postoperative RFS and OS rates in the high NLR,high PLR and low LMR groups were lower.Conclusion High NLR,high PLR and low LMR before radical cystectomy predict poor prognosis of MIBC patients,which can serve as biomarkers for evaluating the clinical prognosis of MIBC patients.