术前外周血中性粒细胞与淋巴细胞比值评估经尿道膀胱肿瘤电切术后非肌层浸润性膀胱癌患者预后的价值

Value of preoperative peripheral blood neutrophil-to-lymphocyte ratio in assessing prognosis of patients with non-muscular invasive bladder cancer after transurethral resection of bladder tumor

目的探讨术前外周血中性粒细胞与淋巴细胞比值(NLR)评估经尿道膀胱肿瘤电切术(TURBT)后非肌层浸润性膀胱癌(NMIBC)患者预后的价值。方法回顾性分析69例NMIBC患者的临床资料,均采用TURBT治疗。根据术前NLR值将患者分为高NLR组(NLR≥3.0)37例和低NLR组(NLR<3.0)32例,比较两组患者的临床资料及预后,分析NMIBC患者TURBT术后预后的影响因素。结果高NLR组患者术后第3年的无肿瘤复发率低于低NLR组患者(P<0.05),而两组术后第1年和第2年两组无肿瘤复发率差异均无统计学意义(均P>0.05)。相对于低NLR组,高NLR组的肿瘤更大、肿瘤的T分期和病理G分级更高、术中切缘阳性率更高(均P<0.05)。肿瘤T1分期、病理G2和G3分级、术前NLR≥3.0是影响NMIBC患者TURBT术后肿瘤复发的独立危险因素(均P<0.05)。结论术前NLR值是NMIBC患者TURBT术后预后的独立影响因素,且与临床病理特征相关,其用于评估NMIBC患者TURBT术后预后具有一定的价值。

Objective To explore the value of preoperative peripheral blood neutrophil-to-lymphocyte ratio(NLR)in assessing the prognosis of patients with non-muscular invasive bladder cancer(NMIBC)after transurethral resection of bladder tumor(TURBT).Methods The clinical data of 69 patients with NMIBC were retrospectively analyzed,and all were treated with TURBT.The patients were divided into high NLR group(NLR≥3.0,n=37)and low NLR group(NLR<3.0,n=32)according to the preoperative NLR value.The clinical data and prognosis of the two groups were compared,and the factors influencing the prognosis of patients with NMIBC after TURBT were analyzed.Results The high NLR group exhibited a lower rate of tumor-free recurrence at year 3 postoperatively than the low NLR group(P<0.05),moreover,there was no statistically significant difference in rate of tumor-free recurrence between the two groups at year 1 and year 2 postoperatively(all P>0.05).Compared with the low NLR group,the high NLR group reported greater tumors,higher stage T and pathological grade G for tumors,and higher positive rate of intraoperative incisal margin(all P<0.05).Tumor stage T1,pathological grades G2 and G3,and preoperative NLR≥3.0 were independent risk factors influencing tumor recurrence in patients with NMIBC after TURBT(all P<0.05).Conclusion Preoperative NLR value is an independent influencing factor of prognosis in patients with NMIBC after TURBT,and it is related to clinicopathological features.Preoperative NLR value has a certain value in assessing the prognosis in patients with NMIBC after TURBT.