The Prognosis Value Of NLR And PLR In Radical Resection Of Muscle-invasive Bladder Cancer

ObjectiveMuscular invasive bladder cancer(MIBC)has a high degree of malignancy and a poor prognosis.At present,radical resection of bladder cancer(RC)+lymph node dissection is the main treatment of MIBC.Previously,it was generally believed in the academic circles that the clinical staging of patients and postoperative tumor pathology grading report of MIBC patients could evaluate the postoperative recovery and prognosis of patients but the prognosis evaluation results often lagged behind and there was a lack of intuitive and quantifiable evaluation data.In contrast,preoperative assessment of some tumor prognostic indicators and specific prognostic assessment results are provided to guide the formulation of disease diagnosis,treatment and prognosis plans and to communicate with patients and their families in advance.Some studies have found that inflammation has the function of promoting tumor invasion of normal cells and rapid metastasis of tumor cells.In a number of studies related to the prognosis of malignant tumors,neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)have been proved to be independent prognostic factors for malignant tumors.In addition,the advantage of using NLR and PLR is that the results can be calculated from blood routine,which is convenient and does not increase the financial burden on patients.However,there are still few domestic and foreign studies on the prognostic relationship between NLR,PLR and MIBC patients with RC,so we decided to discuss whether NLR and PLR can be used as prognostic indicators for MIBC patients with RC.MethodsWe decided to retrospectively analyze the clinicopathological data and postoperative follow-up of MIBC patients undergoing RC in our hospital.All the patients were hospitalized in our hospital from October 2012 to December 2018.Firstly compare the clinical data of MIBC patients and then the threshold values of NLR and PLR in peripheral blood of MIBC patients were obtained by receiver operating characteristic(ROC)curve.Kaplan-Meier method is used to analyze the influence of each clinicopathological feature on the prognosis of patients.The survival curves of total survival time(OS)of MIBC patients are compared by log-rank test.Cox regression model is used for multivariate analysis to search for independent prognostic factors in MIBC patients.ResultsAccording to the ROC curve of MIBC patients,the maximum area under the ROC curve(AUC)of NLR and PLR were 0.739 and 0.611,respectively,which indicated that the NLR threshold value was 2.03 and the PLR threshold value was 125.30.Patients were then divided into two different groups based on ROC thresholds.According to preoperative peripheral NLR and PLR levels patients were divided into high NLR group(NLR?2.03,65 cases)and low NLR group(NLR<2.03,59 cases),and high PLR group(PLR?125.30,37 cases)and low PLR group(PLR<125.30,87 cases).High levels of NLR and PLR can affect the clinical staging of MIBC patients(x2=4.422,P<0.05,x2=3.115,P<0.05).In addition,the results of univariate analysis showed that NLR?2.03(HR=3.503,P=0.001)and PLR?125.30(HR=2.688,P=0.002)could affect the survival time of MIBC patients for 3 years,and the differences were statistically significant.The results of multivariate analysis showed that only NLR?2.03(HR=3.678,P=0.048)was an independent prognostic factor affecting the 3-year survival time of MIBC patients.ConclusionPreoperative high levels of NLR and PLR predicted that patients with MIBC might have worse OS.As an independent prognostic factor of MIBC,NLR was significantly superior to PLR in its predictive value.