淋巴细胞/单核细胞比值对根治性膀胱全切患者生存预后的预测价值

毕海; 覃子健; 刘承; 王国良; 石文君; 黄毅; 马潞林

doi:10.13201/j.issn.1001-1420.2021.05.002

淋巴细胞/单核细胞比值对根治性膀胱全切患者生存预后的预测价值

- 北京大学第三医院泌尿外科(北京, 100191)
基金项目:
北京市自然科学基金(No:L192037)

详细信息

通讯作者: 马潞林,E-mail:malulin@medmail.com.cn

中图分类号: R737.14

收稿日期: 2020-07-22

Predictive role of lymphocyte/monocyte ratio in the survival outcome of patients undergoing radical cystectomy

- Department of Urology, Peking University Third Hospital, Beijing, 100191, China

More Information

Corresponding author: MA Lulin, E-mail: malulin@medmail.com.cn

Received Date: 22 July 2020

摘要

摘要: 目的:探索术前淋巴细胞/单核细胞比值(lymphocyte/monocyte ratio, LMR)对膀胱癌患者行根治性膀胱全切术后生存预后的预测价值。方法:筛选2012—2017年在我院行根治性膀胱全切的膀胱癌患者233例,收集患者围手术期临床病理资料并随访生存数据,采用最大选择检验计算LMR的截点数据,将患者分为高LMR和低LMR两组,通过Kaplan-Meier曲线的log-rank检验两组生存曲线有无差异,同时通过构建Cox多因素回归模型探讨LMR对患者生存预后的预测价值。结果:采用最大选择检验计算LMR的截点值为2.68,高LMR组(LMR>2.68)与低LMR组(LMR≤2.68)相比,患者年龄更小、体重指数(BMI)更高、合并症更少、T分期和N分期更低。低LMR组的中位生存时间为29.9个月,高LMR组的中位生存时间为56.4个月,两组患者的生存曲线存在显著差异(P=0.001 6)。通过Cox多因素回归分析,影响膀胱癌患者生存预后的独立危险因素包括:合并症综合指数(charlson comorbidity index, CCI)(P=0.007)、LMR(P=0.026)、T分期(P=0.036)、变异亚型(P=0.018)和脉管侵犯(P=0.026)。结论:LMR是影响根治性膀胱全切患者生存预后的独立危险因素,术前LMR水平越高,患者的生存预后越好,同时,LMR作为外周血炎症指标,术前能够简便地获得,在患者生存预后的预测中具有重要价值。
- 淋巴细胞/单核细胞比值 /
- 膀胱癌 /
- 膀胱全切 /
- 生存预后
Abstract: Objective: To explore the predictive role of lymphocyte/monocyte ratio(LMR) in the survival outcome of bladder cancer patients undergoing radical cystectomy.Methods: We selected 233 bladder cancer patients who underwent radical cystectomy in Urology Department of Peking University Third Hospital from 2012 to 2017. The patients' perioperative clinic-pathological information and follow-up records were collected. Cutoff point of LMR were selected by using maximum selected log-rank statistic. The patients were divided into two groups: high LMR and low LMR. Log rank test was used to test the difference of survival curve between two groups, and Cox multivariate regression model was used to explore the predictive role of LMR in the patients' survival outcome.Results: The cutoff point of LMR was 2.68 by using maximum selected log-rank statistic. Compared to the low LMR group(LMR≤2.68), the patients of high LMR group were younger and had higher body mass index(BMI), less comorbidity, and lower T stage and N stage. The median survival time of low LMR group was 29.9 months, while the high LMR group was 56.4 months. There was significant difference between two groups' survival curve according to log-rank test(P=0.001 6). In Cox multivariate regression analysis, independent risk factors influencing overall survival of bladder cancer patients included Charlson comorbidity index(CCI)(P=0.007), LMR(P=0.026), T stage(P=0.036), variant subtype(P=0.018) and lymphovascular invasion(P=0.026).Conclusion: LMR was an independent risk factor for overall survival of bladder cancer patients undergoing radical cystectomy, and the higher LMR, the better prognosis. At the same time, LMR was an indicator of peripheral blood inflammation and can be easily obtained preoperatively, so LMR had a significant predictive role in the survival outcome of bladder cancer patients.
- lymphocyte/monocyte ratio /
- bladder cancer /
- radical cystectomy /
- survival outcome

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