Prognostic Significance Of Tins And Tils Combined With NLR In Patients With Muscleinvasive Bladder Cancer After Radical Cystectomy

Objective : To investigate the effect of tumor infiltrating inflammatory cells combined with peripheral blood inflammatory index on prognosis of patients with radical bladder cancer.Methods:Select our hospital from 105(RC)underwent radical cystectomy to treat muscle layer of the patients with invasive bladder cancer(MIBC),collection of peripheral blood in patients with NLR value is divided into low and high value group,immune histochemical method marked tumor infiltrating neutrophils(TINs),degree of infiltrating lymphocytes(TILs)is divided into low infiltration and highly invasive group.Chi-square test was performed to analyze the relationship between TINs,TILs and NLR.Kaplan-meier survival analysis and log-rank test were performed to compare progression-free survival(PFS)and total survival(OS)in each group.COX regression was used to analyze the factors affecting the prognosis of patients.Results:TINs infiltration degree was significantly correlated with pathological stage,grade and tumor size(P<0.05),NLR was correlated with pathological stage(P<0.05),and TILs was not correlated with pathological stage and grade of tumor.Kaplan-meier survival analysis and log-rank test results showed that TILs was correlated with better PFS(P<0.05),while TINs and NLR values showed no significant difference.Both TINs and NLR were associated with poor OS in patients(P<0.05),while high infiltration of TILs was associated with OS extension(P<0.05).In univariate analysis,we found that pathological staging,grade,tumor size,TINs,TILs and NLR were significantly correlated with OS in patients(P<0.05)and were predictors of poor prognosis,among which TILs could be used as a predictor of good prognosis.Multivariate analysis showed that pathological staging(HR 2.389,95%CI 1.021-5.591,P<0.05),TILs(HR 0.415,95%CI 0.200-0.859,P<0.05)and NLR(HR 2.789,95%CI 1.162-6.695,P<0.05)were independent prognostic risk factors for MIBC,with TILs as protective factor.The chi-square test analyzed the correlation between NLR and TINs and TILs,and the results showed that NLR and TINs were not correlated,while NLR and TILs were correlated(P<0.05).Conclusion : Tumorassociated inflammatory cells(including TINs,TILs and NLR)are important markers in predicting the prognosis of MIBC patients.However,pure peripheral blood inflammatory indicators cannot fully represent the degree of infiltration of corresponding inflammatory cells in tumor tissues,and should be combined with local infiltration of inflammatory cells in order to better reflect the relationship between inflammatory response and prognosis of tumor patients.