中性粒细胞/淋巴细胞比值作为非肌肉浸润性膀胱癌复发和进展的预测因子的应用

Nuno Ramos, Celso Marialva, V. Metrogos, J. Rosa, N. Menezes
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摘要

目的:评价中性粒细胞/淋巴细胞比值(RNL)能否预测非肌肉浸润性膀胱癌(CBNMI)患者的复发和进展风险。材料与方法:回顾性分析2013年1月至2014年12月膀胱肿瘤(RTUV)切除术后诊断为CBNMI的患者。手术前没有白细胞计数的患者和同步肿瘤患者被排除在外。随后使用SPSS 22.0®软件进行多变量统计分析,变量包括:年龄、性别、复发或疾病进展时间(以月为单位)、NLR、肿瘤大小(≤3或≤3cm)、多发肿瘤、组织学和肿瘤初始分级。结果:本组84例患者,男性占79.8%,平均年龄69岁。67.9%的患者初始肿瘤组织学为pTa, 77.4%为低级别肿瘤。21.4%的患者有多发肿瘤,33.3%的患者肿瘤大于3cm。19%的患者肿瘤复发,16.4%的患者肿瘤进展。RNL>3.32患者以pT1为初始肿瘤组织学表现较多(p=0.018)。在一项多变量分析中,RNL> 3.32被发现与较高的肿瘤复发或进展相关(危险比[HR] = 2.94;95% ci: 1.27-6.8;p = 0012)。结论:总之,本研究表明RNL可能是CBNMI患者肿瘤复发或进展的有用预测因子,在临床决策中有价值。
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Utilidade da Razão Neutrófilos/Linfócitos como Fator Preditor da Recorrência e da Progressão do Carcinoma da Bexiga Não Músculo Invasivo
Objectives: Assess whether the neutrophil-lymphocyte ratio (RNL) can predict the risk of recurrence and progression of patients with the non–muscle-invasive bladder carcinoma (CBNMI). Material & Methods: It was performed a retrospective analysis of patients diagnosed with CBNMI after a resection of the bladder tumor (RTUV), between January 2013 and December 2014. Patients who had no white blood cell count prior to surgery and patients with synchronous tumors were excluded. It was subsequently performed a multivariate statistical analysis with SPSS 22.0® software, with the following variables: age, gender, time of recurrence or disease progression (in months), NLR, tumor size (≤ 3 or >3cm), multiple tumors, histology and tumor initial grade. Results: The sample consists of 84 patients, 79.8% were males and the average age was 69 years. In 67.9% of the patients the initial tumor histology was pTa and in 77.4% was a low-grade tumor. In 21.4% of patients the tumor was multiple and in 33.3% the tumor was larger than 3 cm. Nineteen-percent of patients had recurrence of tumor and progression was verifyed in 16.4%. Patients with RNL>3.32 presented pT1 as initial tumor histology more often (p=0.018). In a multivariate analysis, the RNL> 3.32 was found to be associated with a higher recurrence or progression of tumor (hazard ratio [HR] = 2.94; 95% CI: 1.27-6.8; p=0012.). Conclusions: In conclusion, this study states that RNL may be an useful predictor of recurrence or progression of tumor in patients with CBNMI, valuable in the clinical decision.
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