Value of preoperative WLR and p16 protein expression in prediction of survival outcomes of patients with penile cancer
Objective To assess the value of preoperative white blood cell to lymphocyte ratio(WLR)and p16 protein expression in the prediction of the survival outcomes of patients with penile cancer.Methods This study is a retrospective cohort study.Ninety-one patients with penile cancer admitted to Xianyang First People's Hospital from January 2018 to January 2020 were selected as the study objects.All the patients took partial penectomy,and were followed up for 3 years after the surgery.According to their prognosis,they were divided into a survival group(58 cases)and a death group(33 cases).The survival group were(61.12±7.13)years old.The death group were(60.88±7.22)years old.The basic information and preoperative imaging results(tumor location,biggest tumor diameter,nerve invasion,lymph node metastasis,and cell differentiation)were compared between the two groups.The levels of vascular endothelial growth factor(VEGF)and tumor necrosis factor receptor-associated protein 1(TRAP1)were detected.The p16 protein expression was assessed.The preoperative white blood cell to lymphocyte ratio(WLR),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and monocyte to lymphocyte ratio(MLR)were calculated.The logistic regression analysis was employed to assess the determinants influencing patient survival.The predictive value of WLR and p16 for postoperative death in the patients was assessed by the receiver operating characteristic curve(ROC).t and x2 tests were applied.Results There were no statistical differences in the basic information,tumor location,biggest tumor diameter,and cell differentiation between the two groups(all P＞0.05).The proportions of the patients with nerve invasion,lymph node metastasis,and positive p16 protein expression in the death group were higher than those in the survival group[63.64％(21/33)vs.32.76％(19/58),57.58％(19/33)vs.31.03％(18/58),and 66.67％(22/33)vs.32.76％(19/58)],with statistical differences(,x2=8.140,6.141,and 9.769;all P＜0.05).The WLR,NLR,PLR,MLR,and levels of VEGF and TRAPl in the death group were higher than those in the survival group[(5.62±0.91)vs.(4.11±0.75),(5.27±0.88)vs.(3.91±0.71),(181.06±25.13)vs.(145.32±20.64),(0.58±0.20)vs.(0.32±0.12),(539.03±52.48)ng/L vs.(442.18±47.36)ng/L,and(58.01±6.63)ng/L vs.(45.25±5.82)ng/L],with statistical differences(t=8.537,8.044,7.331,7.761,9.016,and 9.556;all P＜0.05).The logistic regression analysis indicated that preoperative nerve invasion,lymph node metastasis,p16 protein,VEGF,TRAPl,WLR,NLR,PLR,and MLR were important factors affecting the patients'prognosis(all P＜0.05).The ROC demonstrated that the combination of WLR and p16 protein expression had a predictive accuracy of 0.943(0.896-0.990)for patient death.Conclusion Preoperative measurement of WLR and p16 can help assess the postoperative survival outcomes of patients with penile cancer.
万方数据
维普
