FAR对恶性膀胱尿路上皮肿瘤的预测效果分析

Analysis of predictive effect of FAR on malignant bladder urothelial tumor

目的分析血浆纤维蛋白原与白蛋白比值(fibrinogen to albumin ratio,FAR)对恶性膀胱尿路上皮肿瘤的预测效果。方法选择接受手术治疗的386例膀胱尿路上皮肿瘤患者为研究对象,术前均实施血浆FAR指标检测,术后均进行组织病理切片检查,分析FAR与病理特征的相关性,并通过受试者工作特征(receiver operating characteristic,ROC)曲线评价FAR对恶性膀胱尿路上皮肿瘤的预测效果。结果386例患者术后行病理检查示,22例(5.7%)为膀胱尿路上皮乳头状瘤,66例(17.1%)为低度恶性潜能的乳头状尿路上皮肿瘤,298例(77.2%)为膀胱尿路上皮癌。随着病情进展,血清纤维蛋白原水平与FAR逐渐升高,白蛋白水平逐渐降低(均P<0.05)。298例膀胱尿路上皮癌患者按病理分级,高级别患者的FAR高于低级别患者[(0.124±0.038)vs(0.091±0.026),t=8.902,P=0.001];按病理分期,肌层浸润(T2期+T3期+T4期)患者FAR高于非肌层浸润(Ta期+T1期)患者[(0.131±0.040)vs(0.090±0.036),t=8.482,P=0.001]。FAR界值为0.085时,诊断恶性膀胱尿路上皮肿瘤的曲线下面积(area under curve,AUC)为0.802(95%CI:0.764~0.860),诊断特异度与敏感度分别为88.1%和78.5%。结论FAR对诊断与预测恶性膀胱尿路上皮肿瘤具有较高的应用价值。

Objective To analyze the predictive effect of plasma fibrinogen to albumin ratio(FAR)on malignant bladder urothelial tumors.Methods Totally 386 patients with bladder urothelial tumors undergoing surgical treatment were selected as the research subjects.Plasma FAR was tested before surgery,and histopathological biopsy was performed after surgery to analyze the correlation between FAR and pathological features.The receiver operating characteristic(ROC)curve was used to evaluate the predictive effect of FAR on malignant bladder urothelial tumors.Results Pathological examination was performed in 386 patients.22 patients(5.7%)were confirmed as bladder urothelial papilloma,66 patienrs(17.1%)were papillary urothelial tumors with low malignant potential,and 298 patients(77.2%)were bladder urothelial carcinoma.As the disease progressed,serum fibrinogen levels and FAR gradually increased,and albumin levels gradually decreased(all P<0.05).Two-hundred-and-ninety-eight patients with bladder urothelial carcinoma were classified according to pathology.The FAR of high-grade patients was significantly higher than that of low-grade patients[(0.124±0.038)vs(0.091±0.026);t=8.902,P=0.001].According to the pathological stage,the FAR of the infiltrated patients(T2+T3+T4)was significantly higher than that of the non-muscle infiltrated patients(Ta+T1)[(0.131±0.040)vs(0.090±0.036);t=8.482,P=0.001].When the FAR threshold was 0.085,the area under curvel(AUC)for the diagnosis of malignant bladder urothelial tumors was 0.802(95%CI:0.764-0.860),and the diagnostic specificity and sensitivity were 88.1%and 78.5%respectively.Conclusion FAR is of high application value in the diagnosis and prediction of malignant bladder urothelial tumors.