NLR、IL-10水平在膀胱癌中的临床意义及对术后1年内肿瘤复发的预测效能

Clinical significance of NLR and IL-10 levels in patients with bladder cancer and prediction of tumor recurrence within 1 year after surgery

目的观察外周血中性粒细胞与淋巴细胞比值(NLR)及尿液中白细胞介素-10(IL-10)水平表达在膀胱癌患者中的临床意义及对术后1年内肿瘤复发的预测效能。方法选取2019年1月至2021年1月在本院收治的112例膀胱癌患者的临床资料,治疗前记录患者的基线资料,并检测外周血NLR和尿液IL-10水平,行腹腔镜下膀胱根治性切除术治疗,术后随访8~12个月,评估患者的肿瘤复发情况,并将其分为复发组(22例)和未复发组(90例)。比较两组的基线资料、外周血NLR及尿液IL-10水平,采用回归分析检验膀胱癌患者外周血NLR及尿液IL-10水平与术后1年内肿瘤复发的关系,并分析外周血NLR及尿液IL-10水平对术后1年内肿瘤复发的预测效能。结果复发组的低分化、合并淋巴结转移占比、外周血NLR及尿液IL-10水平均高于未复发组(均P<0.05)。经logistic回归分析结果显示,低分化、合并淋巴结转移、外周血NLR及尿液IL-10高水平是膀胱癌患者术后1年内肿瘤复发的危险因素(OR>1,均P<0.05)。膀胱癌患者的外周血NLR、尿液IL-10水平单项及联合检测预测术后肿瘤复发的曲线下面积(AUC)均高于0.80。不同分化程度、合并和未合并淋巴结转移患者间的NLR、IL-10水平比较,差异均无统计学意义(均P>0.05)。结论膀胱癌患者术后1年内肿瘤复发风险高,与肿瘤分化程度、合并淋巴结转移、外周血NLR及尿液IL-10水平均有关,其中外周血NLR及尿液IL-10水平可作为术后肿瘤复发的预测指标。

ObjectiveTo observe the clinical significance of peripheral blood neutrophil-lymphocyte ratio(NLR)and urine interleukin-10(IL-10)expression in patients with bladder cancer and its predictive effect on recurrence within one year after operation.MethodsThe clinical data of 112 patients with bladder cancer admitted to our hospital from January 2019 to January 2021 were selected.Before treatment,the baseline data of patients were recorded in detail,and the levels of NLR in peripheral blood and IL-10 in urine were detected.Laparoscopic radical cystectomy was performed.The patients were followed up for 8-12 months to evaluate the tumor recurrence,and were divided into the recurrence group(22 cases)and the non recurrence group(90 cases).The baseline data,peripheral blood NLR and urine IL-10 levels were compared between the two groups.Regression analysis was used to examine the relationship between peripheral blood NLR and urine IL-10 levels and tumor recurrence within 1 year after surgery in bladder cancer patients.The predictive efficacy of peripheral blood NLR and urine IL-10 levels on recurrence within 1 year after surgery were analyzed.ResultsThe proportion of low differentiation,concurrent lymph node metastasis,peripheral blood NLR,and urine IL-10 levels in the recurrence group were higher than those in the non recurrence group(all P<0.05).Logistic regression analysis showed that poor differentiation,lymph node metastasis,high levels of peripheral blood NLR and urine IL-10 were risk factors for tumor recurrence in bladder cancer patients within one year after surgery(OR>1,all P<0.05).The area under the curve(AUC)of the peripheral blood NLR and urine IL-10 levels in patients with bladder cancer to predict tumor recurrence after surgery individually and jointly were all higher than 0.80.There was no statistical significant difference in NLR and IL-10 levels between patients with different degrees of differentiation,with and without lymph node metastasis(all P>0.05).ConclusionsPatients with bladder cancer have a high risk of recurrence within one year after operation,which is correlated with tumor differentiation,lymph node metastasis,peripheral blood NLR and urine IL-10 levels.Among them,peripheral blood NLR and urine IL-10 levels can be used as predictive indicators of tumor recurrence after surgery.