The Prognostic Value Of Preoperative C-Reactive Protein/Albumin Ratio In Bladder Cancer Patients After Radical Cystectomy

Aim: The incidence of bladder cancer accounts for 3% in global cancers.In China,it has ranked as the first common cancer of urinary tumors and the incidence and mortality have been increasing in recent decades.Bladder cancer can be divided into non-muscle invasive bladder cancer and muscle-invasive bladder cancer according to the depth of tumor invasion and radical cystectomy is a commonly used surgical treatment for muscular invasive bladder cancer.However,the recurrence rate of patients with bladder cancer is high and the overall prognosis of patients is poor.Therefore,it is necessary to study some effective clinical biomarkers to analyze the prognosis of patients after radical cystectomy.Recently,more and more studies have shown that inflammatory factors and nutritional status play an important role in predicting the prognosis of various types of cancer.The ratio of C-reactive protein to Albumin is related with the prognosis of kidney cancer,prostate cancer,esophageal cancer,gastric cancer,etc.But the relationship between the ratio of C-reactive protein to Albumin with the prognosis of bladder cancer has not been reported.This article validates the ratio of C-reactive protein to Albumin(CRP/ALB)and the prognostic significance of patients after radical cystectomy with bladder cancer.Method: From January 1,2015 to August 31,2018,all bladder cancer patients who underwent radical cystectomy at the Xuzhou Central Hospital were included.A total of 103 patients were included.The last follow-up period was September 2019.Complete data of blood tests performed within 1 weeks before the enrollment of patients.Basic patient data,tumor-related indicators,and preoperative serum indicators were cillected.X-tile software was used to determine the best cutoff value and SPSS 20.0 software was used for statistical processing.Chi-square test was used to test the relationship between the ratio of C-reactive protein to Albumin and clinicopathological characteristics was tested by Chi-square test.The Kaplan-Meier survival curve was used to compare and analyze the overall survival of different C-reactive protein to Albumin ratio levels.The univariate and multivariate risk factors affecting overall survival were analyzed by the Cox regression model.Result:103 patients were followed up for 10-55 months,of which 11 were lost to follow-up.Kaplan-Meier survival curve analysis showed that the overall survival time of patients with bladder cancer with high C-reactive protein to Albumin ratio was significantly lower than C-The ratio of reactive protein to Albumin was lower(P<0.001).Cox regression analysis showed tumor size(HR:13.628;95% CI: 1.790-103.731;P=0.012),tumor invasion depth stage(HR: 13.845;95% CI:1.799-106.566;P=0.012),tumor metastasis(HR:0.283;95% CI: 0.1100-0.801;P=0.017)and high C-reactive protein to Albumin ratio(HR:2.485;95% CI:1.048-5.894;P=0.019)affect the postoperative radical cystectomy Independent Factors for Overall Survival in Patients with Bladder Cancer.Conclusion: The ratio of C-reactive protein to Albumin is used as an independent marker to predict the prognostic index after radical cystectomy in bladder cancer patients.According to the levels of C-reactive protein and Albumin,bladder cancer patients can be stratified and it was conductive to choose more appropriate treatment strategies.