The Clinical Value Of Preoperative Peripheral Inflammatory Indexes In The Prognostic Evaluation Of Non-muscular Invasive Bladder Cancer

Objective: To investigate the clinical significance of preoperative peripheral blood inflammatory markers for predicting postoperative recurrence of non-muscle invasive bladder cancer(NMIBC)in patients undergoing Transurethral resection of bladder tumor(TURBT).Methods: Clinical case data of 216 patients admitted to our department from January 2010 to December 2014 who were pathologically confirmed as NMIBC after routine surgery were selected for prognostic correlation analysis.Neutrophi-lymphocyte ratio(NLR),Platelet-lymphocyte ratio(PLR),lymphocyte-monocyte ratio(LMR),and Fibrinogen(FIB)were calculated according to blood routine results within one week before surgery.The optimal critical value of peripheral blood inflammatory indicators was determined by median method and divided into high and low value groups.Kaplan-meier curve was used to analyze the relationship between four inflammatory indicators including NLR,PLR,LMR and FIB and postoperative tumor recurrence in patients,and the relapse-free Survival(RFS)of patients in each group was compared.Cox regression model was used to determine independent risk factors for tumor recurrence in patients with NMIBC.Results: The optimal critical values of NLR,PLR,LMR and FIB were determined by median method,and the patients were divided into high and low value groups.Among them,patients in the high NLR group had higher tumor stage and worse tumor differentiation than those in the low NLR group,with statistically significant differences(P<0.05).Patients in the high PLR group had higher tumor stage and larger tumor diameter than those in the low PLR group,and the difference was statistically significant(P<0.05).Patients in the low LMR group had more smokers and more tumors than those in the high LMR group,and the difference was statistically significant(P<0.05).Patients in the high-fib group were older,had worse tumor differentiation and had more tumors than those in the low-fib group,with statistically significant differences(P<0.05).The results of single factor analysis showed that tumor stage,tumor differentiation degree,NLR,LMR and FIB were closely related to postoperative RFS of NMIBC patients.The 1-,3-and 5-year recurrence-free survival rates of patients with high NLR and high FIB were significantly lower than those with low NLR and low FIB.Further multi-factor analysis showed that high tumor stage,poor tumor differentiation and NLR?2.4 and FIB?3.0 were independent risk factors affecting patients' RFS.Conclusion: The high preoperative NLR and FIB values are independent predictors of poor prognosis after TURBT surgery in NMIBC patients,and are expected to be indicators of prognosis.