Preoperative neutrophil-lymphocyte ratio and fibrinogen level in patients distinguish between muscle-invasive bladder cancer and non-muscle-invasive bladder cancer.
Preoperative neutrophil-lymphocyte ratio and fibrinogen level in patients distinguish between muscle-invasive bladder cancer and non-muscle-invasive bladder cancer.
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DOI：
10.2147/ott.s107445
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发表时间：
2016
影响因子：
4
通讯作者：
Sun E
中科院分区：
文献类型：
--
作者：
Ma C;Lu B;Diao C;Zhao K;Wang X;Ma B;Lu B;Sun E
本研究的目的是探讨术前中性粒细胞-淋巴细胞比率（NLR）和纤维蛋白原水平是否有助于区分肌层浸润性膀胱癌（MIBC）和非肌层浸润性膀胱癌（NMIBC）。我们确定了 669 名在我们机构接受手术的患者，并评估了他们的术前 NLR 和纤维蛋白原水平。根据术后病理情况将患者分为两组，NMIBC（I组）和MIBC（II组）。对于组间比较，使用独立样本t检验评估从两组获得的数据。 NLR、纤维蛋白原水平以及综合NLR和纤维蛋白原水平的截断值由接受者操作特征(ROC)曲线确定。 I组和II组的平均NLR分别为2.71±2.46和4.66±8.00（P<0.001）。两组纤维蛋白原水平分别为~3.13±0.70 g/L和3.41±0.84 g/L（P=0.001）。采用ROC曲线评价NLR、纤维蛋白原水平以及NLR和纤维蛋白原综合水平是否有助于区分MIBC和NMIBC。根据Youden指数估计NLR的截断值为2.01。以此值，敏感性为67.1%，特异性为52.7%，受试者工作特征（ROC）曲线下面积（AUC）为0.601（P=0.031）。根据约登指数估计纤维蛋白原水平的临界值为3.17 g/L。因此，敏感性为 58%，特异性为 58%，AUC 为 0.60（P=0.001）。综合 NLR 和纤维蛋白原水平的截止值为 0.166；敏感性为86%，特异性为42%，AUC为0.801（P=0.01）。本研究获得的数据表明，如果 NLR > 2.01，则 67.1% 的 Ta-T1 肿瘤可能具有侵袭性，如果纤维蛋白原水平 > 3.17 g/L，则 58% 的 Ta-T1 肿瘤可能具有侵袭性。当我们同时使用 NLR 和纤维蛋白原水平来区分 MIBC 和 NMIBC 时，发现敏感性为 86%，特异性为 42%。
The aim of this study was to explore if the preoperative neutrophil–lymphocyte ratio (NLR) and fibrinogen level can help in distinguishing between muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). We identified 669 patients who underwent surgery at our institution, and evaluated their preoperative NLRs and fibrinogen levels. Patients were divided into two groups, NMIBC (group-I) and MIBC (group-II), according to the postoperative pathology. For the intergroup comparison, data obtained from the two groups were evaluated using independent samples t-test. The cutoff value of the NLR, fibrinogen level, and integrated NLR and fibrinogen level was determined with receiver operating characteristic (ROC) curve. The mean NLRs of group-I and group-II were found as 2.71±2.46 and 4.66±8.00, respectively (P<0.001). The fibrinogen levels of the two groups were ~3.13±0.70 g/L and 3.41±0.84 g/L, respectively (P=0.001). Whether the NLR, fibrinogen level, and integrated NLR and fibrinogen level can help in distinguishing between MIBC and NMIBC was evaluated with ROC curve. The cutoff value of NLR was estimated as 2.01 according to the Youden index. With this value, sensitivity was found as 67.1%, specificity was 52.7%, and area under receiver operating characteristic (ROC) curve (AUC) was 0.601 (P=0.031). The cutoff value of fibrinogen level was estimated as 3.17 g/L according to the Youden index. Accordingly, sensitivity was found as 58%, specificity was 58%, and AUC was 0.60 (P=0.001). The cutoff value of integrated NLR and fibrinogen level was found as 0.166; the sensitivity was found as 86%, specificity was 42%, and AUC was 0.801 (P=0.01). The data obtained in this study suggested that 67.1% of Ta-T1 tumors were likely to be invasive if the NLR was >2.01 and 58% were likely to be invasive if the fibrinogen level was >3.17 g/L. When we used both the NLR and fibrinogen level to distinguish between the MIBC and NMIBC, sensitivity was found to be 86%, and specificity was 42%.