首页|全身炎症反应指数评估高级别非肌层浸润性膀胱癌患者预后的价值

全身炎症反应指数评估高级别非肌层浸润性膀胱癌患者预后的价值

Evaluation of prognosis in patients with high-grade non-muscle invasive bladder cancer using systemic inflammatory response index

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目的 探究全身炎症反应指数(SIRI)在高级别非肌层浸润性膀胱癌(NMIBC)患者预后中的评估价值,为高级别NMIBC患者的诊治提供新的思路.方法 回顾性分析2019年1月1日-2020年1月1日在蚌埠医科大学第一附属医院泌尿外科行经尿道膀胱肿瘤电切术(TURBT)的40例高级别NMIBC患者的临床资料,根据患者术后是否出现肿瘤复发,绘制ROC曲线以确定SIRI最佳截断值,并作为截点将患者分为高值组和低值组,分析SIRI对高级别NMIBC患者预后的影响.结果 绘制SIRI预测预后(有无复发)的ROC曲线,得出SIRI最佳截断值为1.46,根据最佳截断值将患者分为高SIRI组(SIRI≥ 1.46,18例)与低SIRI组(SIRI<1.46,22例).高、低SIRI组间肿瘤大小比较差异有统计学意义,高SIRI患者术前肿瘤最大径≥3 cm的可能性较大.生存分析显示,不同SIRI、肿瘤数量、肿瘤大小组间无复发生存期(RFS)差异有统计学意义,即低SIRI组患者的生存情况优于高SIRI组、肿瘤单发患者的生存情况优于多发患者、肿瘤最大径<3 cm患者的生存情况优于肿瘤最大径≥3 cm患者.Cox单因素分析结果显示,SIRI、肿瘤数量和肿瘤大小是高级别NMIBC患者术后RFS的独立影响因素;Cox多因素分析结果显示,SIRI≥1.46是NMIBC患者术后RFS的独立危险因素.结论 SIRI可以作为高级别NMI-BC患者的风险评估指标,可能为高级别NMIBC治疗带来新的方案和方向.
Objective The systemic inflammatory response index(SIRI)was used to evaluate the prognosis of high-grade non-muscle invasive bladder cancer(NMIBC)patients,which provided new ideas and theoretical value for the di-agnosis and treatment of patients with high-grade NMIBC.Methods A total of 40 cases with high-grade NMIBC who un-derwent transurethral resection of bladder tumor(TURBT)in the First Affiliated Hospital of Bengbu Medical University from January 1,2019 to January 1,2020 were analyzed retrospectively.According to whether the patient has a tumor re-currence after surgery,the working subjects operated the characteristic curve(ROC)to determine the best cutoff value of SIRI and divided it into high-value group and low-value group,so as to determine the influence on the prognosis of high-grade NMIBC patients.Results The ROC curve of SIRI to predict prognosis(with or without recurrence)is drawn,and the best cut-off value of SIRI was 1.46.According to the optimal cut-off value,patients were divided into high SIRI group(SIRI≥1.46,18 cases)and low SIRI group(SIRI<1.46,22 cases).Tumor size varied in the distribution between the high and low SIRI groups.Patients with high SIRI were more likely to have a 3 cm maximum tumor diameter before sur-gery.Survival analysis showed that there were significant differences in SIRI,tumor number,and recurrence-free survival(RFS)during different size of tumors.The survival of patients with low SIRI was better than that of patients with high SIRI.Patients with single tumor were better than patients with multiple tumors,and patients with maximum tumor diame-ter less than 3 cm were better than patients with tumor diameter more than 3 cm.Cox univariate analysis confirmed that SIRI,tumor number,and tumor size were independent influencing factors for postoperative RFS in the advanced group.Cox multivariate analysis confirmed that SIRI more than 1.46 was an independent risk factor for postoperative RFS in NMIBC patients.Conclusion SIRI can be used as a risk assessment index for patients with high-grade NMIBC,which can provide new options and directions for the treatment of high-grade NMIBC.

Non-muscular invasive bladder cancerSystemic inflammatory response indexHigh gradePrognosis

凌能勇、汪盛

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蚌埠医科大学第一附属医院泌尿外科,安徽蚌埠 233004

非肌层浸润性膀胱癌 全身炎症反应指数 高级别 预后

安徽省自然科学基金项目

1808085MH293

2024

中华全科医学
中华预防医学会,安徽省全科医学会

中华全科医学

CSTPCD
影响因子:1.688
ISSN:1674-4152
年,卷(期):2024.22(7)