NLR、AGR、血脂指标对膀胱癌患者预后的影响

Influence of NLR, AGR and Blood Lipid Indexes on the Prognosis of Bladder Cancer Patients

目的 探讨术前中性粒细胞/淋巴细胞比值(NLR)、前白蛋白(AGR)、血脂指标与膀胱癌患者预后的关系。方法 选择2016年12月~2021年12月于我院确诊并行膀胱癌根治术治疗的膀胱癌患者106例,收集其术前一般资料、手术相关情况及NLR、AGR、血脂指标低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC),通过Log-rank法和多因素Cox回归模型对NLR、AGR、血脂指标与膀胱癌患者的癌症特异性生存率(CSS)相关性进行统计学分析。结果 106例患者中共42例患者死亡,累计死亡率39.62%,定义为预后不良组;共64例患者未发生终点事件,累计CSS 60.38%,定义为预后良好组。NLR、AGR、TG、HDL-C高表达患者CSS低于NLR、AGR、TG、HDL-C低表达患者(P<0.05),高水平的NLR、AGR、TG、HDL-C水平是影响膀胱癌患者CSS的独立影响因素(P<0.05)。结论 肿瘤病理分级、肿瘤临床分期、NLR、AGR、TG、HDL-C水平不同的膀胱癌患者生存率存在差异,且高水平的NLR、AGR、TG、HDL-C与膀胱癌术后患者低CSS相关,可作为预测患者预后的预测因子。

Objective To investigate the relationship of preoperative neutrophil-to-lymphocyte ratio(NLR), anterior gradient protein(AGR), blood lipid indexes with the prognosis of patients of bladder cancer. Methods A total of 106 patients with bladder cancer underwent radical cystectomy in our hospital from December 2016 to December 2021 were enrolled. Various indexes were obtained, including general information, operation related indicators, NLR, AGR,low density lipoprotein cholesterol(LDL-C), triglycerides(TG), high density lipoprotein cholesterol(HDL-C), total cholesterol(TC). The Log-rank method and multivariate Cox regression were used to analyze the correlation between NLR,AGR, blood lipids and the Cancer-Specific Survival(CSS) of patients with bladder cancer. Results A total of 42(poor prognosis group) of 106 patients died, with a cumulative mortality rate of 39.62%. A total of 64 patients(good prognosis group) did not have an endpoint event, and the cumulative CSS rate was 60.38%. CSS of patients with high expression of NLR, AGR, TG and HDL-C was significantly lower than that of patients with low expression of NLR, AGR, TG and HDL-C(P<0.05). High levels of NLR, AGR, TG and HDL-C were independent factors of CSS in patients with bladder cancer(P<0.05). Conclusion The survival rates of bladder cancer patients with different tumor pathological grades, tumor clinical stages, NLR, agr, TG and HDL-C levels are different.High levels of NLR, AGR, TG, and HDL-C are associated with low postoperative CSS in patients with bladder cancer, so the four indexes can be used as predictors of patient prognosis.