预后营养指数和系统免疫炎症指数对根治性膀胱切除术后病理分期的预测价值

目的探讨预后营养指数(PNI)和系统免疫炎症指数(SII)对根治性膀胱切除术(RC)后肿瘤病理分期的预测价值。方法回顾性收集2011年4月—2019年10月于天津医科大学第二医院接受RC的195例膀胱癌患者的信息。提取患者术前实验室检查数据并计算PNI和SII,计算公式为PNI=白蛋白(g/L)+5×淋巴细胞总计数(10°/L);SII=血小板×中性粒细胞/淋巴细胞。采用单因素和多因素Cox回归分析评估PNI和SII能否作为肌层浸润性膀胱癌和非肌层浸润性膀胱癌的预测因素。连续变量组间比较采用t检验;分类变量组间比较采用χ^2检验。生成受试者操作特征曲线(ROC),计算曲线下面积(ALC)来判断PNI和SII的预测能力。AUC越大,预测能力越强。采用单因素和多因素Cox回归分析计算相应的优势比(OR)和95%CI。结果所有患者均为男性,平均年龄为(67.94±8.97)岁,平均血清白蛋白为(42.13±4.28)g/L,平均PNI为51.29±6.09,平均SII为661.67±506.22。单因索Cox回归分析结果表明,PNI和SII对肌层浸润性膀胱癌的发病率均有统计学意义;多因素Cox回归分析结果表明,PNI和SII不能作为肌层浸润性膀胱癌和非肌层浸润性膀胱癌的预测因素。而PNI是预测肿瘤分期的独立危险因素(pT<3a和pT≥3a)。结论术前较低的PNI可以作为预测较差病理分期(pT≥3a)的独立因素。

Predictive value of prognostic nutritional index and systemic immune-inflammation index on tumor progression in bladder cancer patients after radical cystectomy

Objective To explore the predlictive value of preoperative prognostic nutritional index(PNI)and systemic immune-inflammation index(SIl)for local tumor stage in bladder cancer after radical cystectomy(RC).MethodsThis stuly is a retrospective study,collectingr information on 195 patients with bladder cancerwho unlerwent RC at the Second Hospital of Tianjin Medlical University from April 201l to October 2019.Extractthe patient's preoperative laboratory examination and calculate the PNI and SII.The calculation formula was PNIl=albumin(g/L.)+5x total lymphocyte count(10°/L);sll=platelets x neutrophils/lymphocytes.Univariate andmultivariate Cox regression analysis were used to analyze whether PNl and Sll can be used as predlictors of muscularinvasive bladder eancer(MIBC)and non-muscular invasive blader cancer(NMIBC).Continuous variables wereexpressed as mean±standard deviation(Mean±SD),and t-test was used for comparison betwen groups;Chi-square test was used for comparison of eategorical variables hetween groups.Generate receiver operatingcharacteristic curve(ROC),caleculate area under the curve(AUC)to judge the predictive ability of PNI and SII scoring indicators.The larger of AUC,the stronger the predlictive ability.Univariate and multivariate Cox regressionanalysis were used to calculate the coresponding odds ratio(OR)and 95%CI.Results All patients were males,with a mean age of(67.94±8.97)years.Mean serum albumin was(42.13±4.28)g/L,mean PNI was 51.29±6.09 andl mean Sll was 661.67±506.22.Univariate Cox regression analysis showed that both PNI and SII hadstatistical significance for the incidence of MIBC;multivariate Cox regression analysis showed that PNI and SII could not be used as the diagnosis of MIBC and NMIBC.PNI was an independent risk factor for predlicting tumorstage(pT<3a and pT≥3a).Conclusion The low preoperative PNI can be used as an independent factor forpredicting poor poathaological stage(pT≥3a).