杜君, 段鹏强, 张超, 姚欣. 术前全身炎症反应指数对中高危非肌层浸润性膀胱癌预后的影响[J]. 中国肿瘤临床, 2023, 50(16): 829-833. DOI: 10.12354/j.issn.1000-8179.2023.20230616
引用本文: 杜君, 段鹏强, 张超, 姚欣. 术前全身炎症反应指数对中高危非肌层浸润性膀胱癌预后的影响[J]. 中国肿瘤临床, 2023, 50(16): 829-833. DOI: 10.12354/j.issn.1000-8179.2023.20230616
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Jun Du, Pengqiang Duan, Chao Zhang, Xin Yao. Impact of preoperative systemic inflammatory response index on the prognosis of intermediate-to-high-risk non-muscle invasive bladder cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(16): 829-833. DOI: 10.12354/j.issn.1000-8179.2023.20230616
Citation: Jun Du, Pengqiang Duan, Chao Zhang, Xin Yao. Impact of preoperative systemic inflammatory response index on the prognosis of intermediate-to-high-risk non-muscle invasive bladder cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(16): 829-833. DOI: 10.12354/j.issn.1000-8179.2023.20230616
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术前全身炎症反应指数对中高危非肌层浸润性膀胱癌预后的影响

Impact of preoperative systemic inflammatory response index on the prognosis of intermediate-to-high-risk non-muscle invasive bladder cancer

    摘要
  • 摘要:
      目的  探讨术前全身炎症反应指数（systemic inflammatory response index，SIRI）对中高危非肌层浸润性膀胱癌（non-muscle invasive bladder cancer，NMIBC）预后的影响。
      方法  回顾性分析2013年1月至2015年7月于天津医科大学肿瘤医院行经尿道膀胱肿瘤电切术（transurethral resection of bladder tumor，TURBT）治疗的103例NMIBC患者的临床资料，根据术后患者有无复发或进展分为复发组和未复发组以及进展组和未进展组。根据组间比较结果，绘制SIRI的受试者工作特征曲线（receiver operating characteristic curve，ROC），求得最优截断值对患者进行分组。通过Kaplan-Meier法和Cox单因素及多因素分析确定影响NMIBC患者预后的危险因素。
      结果  SIRI值在复发患者和未复发患者间差异无统计学意义（P=0.393）；患者的年龄（P=0.016）、性别（P=0.030）、肿瘤数目（P=0.008）、分期（P<0.001）、分级（P<0.001）、是否初发（P=0.002）、单核细胞计数（P=0.042）以及SIRI（P=0.044）差异具有统计学意义；根据ROC曲线确定SIRI鉴定患者术后是否出现进展的最佳临界值 ，将患者分为低SIRI组和高SIRI组，生存分析对比两组间的无进展生存期（progression-free survival，PFS）差异具有统计学意义（P=0.005）。Cox多因素分析结果显示，肿瘤数目（P=0.041）、是否初发（ P=0.041）及SIRI≥0.725（P=0.025）是NMIBC 患者TURBT术后PFS的独立预后因素。
      结论  SIRI是影响中高危NMIBC患者进展的独立危险因素，术前SIRI对预测肿瘤分期有一定的应用价值。

     

    Abstract:
      Objective  To investigate the impact of a preoperative systemic inflammatory response index (SIRI) on the prognosis of intermediate-to-high-risk non-muscle invasive bladder cancer (NMIBC).
      Methods  The clinical data of 103 patients with NMIBC who underwent transurethral resection of bladder tumor (TURBT) at Tianjin Medical University Cancer Institute & Hospital from January 2013 to July 2015 were retrospectively analyzed. Patients were grouped according to whether the NMIBC recurred and progressed. The receiver operating characteristic (ROC) curve was used to determine the best critical values of SIRI. Prognostic factors affecting the outcome of patients with NMIBC were assessed using Kaplan–Meier analysis and Cox univariate and multivariate analyses.
      Results  SIRI values were not significantly different between the recurrent and non-recurrent patient groups (P=0.393). Age (P=0.016), sex (P=0.030), number of tumors (​​​​​​​P=0.008), stage (​​​​​​​P<0.001), grade (​​​​​​​P<0.001), primary tumors (​​​​​​​P=0.002), monocyte count (​​​​​​​​​​​​​​P=0.042）, and SIRI (​​​​​​​​​​​​​​P=0.044) were significantly different between patients who progressed and those who did not. The optimal cut-off value of SIRI identifying postoperative progression was determined according to the ROC curve, and the patients were assigned into the low and high SIRI groups. The progression-free survival (PFS) between the two groups was significantly different. Cox multivariate analysis showed that tumor number, primary tumor, and SIRI≥0.725 were independent prognostic factors for PFS in patients with NMIBC following TURBT.
      Conclusions  SIRI is an independent risk factor affecting the progression of patients with intermediate-to-high-risk NMIBC. Thus, preoperative SIRI has a certain application value for predicting tumor staging.

     

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