| Background: In China,bladder cancer is one of the most common malignant tumors of the urinary system,and its incidence ranks the first among the malignant tumors of the genitourinary system.Bladder tumor is mainly treated by surgery,which should be selected according to the clinical stage,pathological results and patient’s whole body condition.Chemotherapy and radiotherapy are used only as adjuvant therapy.The pathological stage,grade and treatment of tumor are directly related to the survival prognosis of patients.In clinical work,the exact pathological results of bladder tumor can only be obtained after surgery.At present,there is no definite preoperative biochemical index that can indicate theclinical stage and pathological stage of tumor.In recent years,a large number of studies have confirmed that the occurrence and development of tumors are closely related to inflammation.Some scholars have pointed out that both the increase of globulin level and the decrease of albumin level are of great significance to reflect the chronic inflammation of the body.Albumin and globulin ratio is the combination of the above two indicators,which has certain predictive significance for the adverse pathology and prognosis of various tumors.Previously,the research field of AGR in urinary system tumors was mostly limited to assessing the prognosis of upper urinary tract tumors and bladder cancer,while there were few studies on the relationship between AGR and pathological features,such as pathological stages and grades of bladder tumors.Objectives: The purpose of this study was to evaluate the relationship between preoperative AGR and pathological character in patients with bladder cancer,and assess predictive value of AGR on pathology and diagnosis in bladder cancer patients.Methods: A total of 109 patients with non muscle-invasive bladder cancer(NMIBC)and 59 patients with muscle-invasive bladder cancer(MIBC)were followed up and the other 100 healthy people was selected as control group.The patient’s age,gender,T stage,grade,tumor number,tumor size,were collected.Patients with non invasive bladder cancer were divided into high and low-value groups according to the median AGR level(1.66).Patients with invasive bladder cancer were divided into high and low-value groups according to the median AGR level(1.40).Depending on the level of AGR,use receiver operator characteristic curve(ROC curve)to determine the optimal AGR cut-off value to distinguish between non muscle-invasive bladder cancer patients and muscle-invasive bladder cancer patients.Results: Among the 168 patients,128 were male and 40 were female.The average age of the patients was65.5 years,the median age was 67 years,the youngest was 45 years,and the largest was 78 years.There were 109 cases of Ta and T1,and 59 casesof T2 and T3.The AGR value was significant between normal healthy people and the cancer patients.The AGR value was also significant between NMIBC patients and MIBC patients.The difference of preoperative AGR value was significant in the tumor T stage,grade,size and number of tumors of NMIBC patients.AGR value was significant in the tumor T stage and grade of MIBC patients.There was no significant difference in age and gender in the comparison of clinical characteristics between the low AGR group and the high AGR group in NMIBC.The age and gender factors in the comparison of clinical characteristics between the low AGR group and the high AGR group in MIBC were not statistically significant.Receiver operator characteristic curve was obtained based on whether the patient was invasive bladder cancer.The sensitivity and specificity were 0.7627 and 0.6422 respectively.The optimal cut-off point of ROC is 1.55,and the area under the curve is 0.766.Conclusion:The inflammatory marker AGR is likely to provide an economical and feasible method to assist in the identification of MIBC and NMIBC. |
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