Preoperative Prognostic Nutritional Index is a Significant Predictor of Survival with Bladder Cancer after Radical Cystectomy: a retrospective study.
Preoperative Prognostic Nutritional Index is a Significant Predictor of Survival with Bladder Cancer after Radical Cystectomy: a retrospective study.
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术前预后营养指数是根治性膀胱切除术后膀胱癌生存的重要预测因子：一项回顾性研究
DOI：
10.1186/s12885-017-3372-8
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发表时间：
2017-06-02
期刊：
影响因子：
3.8
通讯作者：
Zhou LQ
中科院分区：
文献类型：
--
作者：
Peng D;Gong YQ;Hao H;He ZS;Li XS;Zhang CJ;Zhou LQ
为了探讨术前预后营养指数（PNI）在膀胱癌根治术后的预后意义，并比较基于炎症指标的预后能力，我们回顾性分析了2006年至2012年在我院接受根治性膀胱癌的516例患者的数据。通过治疗前测量评估临床病理特征和基于炎症的指标（PNI、中性粒细胞/淋巴细胞比率[NLR]、血小板/淋巴细胞比率[PLR]、淋巴细胞/单核细胞比率[LMR]）。采用Kaplan-Meier法估计总生存期（OS）和无进展生存期（PFS），并采用对数秩检验进行比较。采用多变量分析和考克斯比例风险模型确认单变量分析中确定的预测因子。临床病理特征和PNI或NLR之间的关联进行了tested.ResultsAmong的516例患者，中位随访时间为37个月（四分位数范围20至56）。多变量分析显示，PNI和NLR分别独立预测OS（PNI：HR = 1.668，95%CI：1.147- 2.425，P = 0.007; NLR：HR = 1.416，95%CI：1.094- 2.016，P = 0.0149）和PFS（PNI：HR = 1.680，95%CI：1.092- 2.005，P = 0.015; NLR：HR = 1.550，95%CI：1.140- 2.388，P = 0.008）。低PNI预测所有病理分期的OS和T1和T2分期的PFS更差。结论PNI和NLR是膀胱癌根治术后OS和PFS的独立预测因子，PNI可能是膀胱癌新的可靠生物标志物。
BackgroundTo explore the prognostic significance of preoperative prognostic nutritional index (PNI) in bladder cancer after radical cystectomy and compare the prognostic ability of inflammation-based indices.MethodsWe retrospectively analyzed data for 516 patients with bladder cancer who underwent radical cystectomy in our institution between 2006 to 2012. Clinicopathologic characteristics and inflammation-based indices (PNI, neutrophil/lymphocyte ratio [NLR], platelet/lymphocyte ratio [PLR], lymphocyte/monocyte ratio [LMR]) were evaluated by pre-treatment measurements. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan–Meier method and compared by log-rank test. Multivariate analysis with a Cox proportional hazards model was used to confirm predictors identified on univariate analysis. The association between clinicopathological characteristics and PNI or NLR was tested.ResultsAmong the 516 patients, the median follow-up was 37 months (interquartile range 20 to 56). On multivariate analysis, PNI and NLR independently predicted OS (PNI: hazard ratio [HR] = 1.668, 95% CI: 1.147–2.425,P= 0.007; NLR: HR = 1.416, 95% CI:1.094–2.016,P= 0.0149) and PFS (PNI: HR = 1.680, 95% CI:1.092–2.005,P= 0.015; NLR: HR = 1.550, 95% CI:1.140–2.388,P= 0.008). Low PNI predicted worse OS for all pathological stages and PFS for T1 and T2 stages. Low PNI was associated with older age (>65 years), muscle-invasive bladder cancer, high American Society of Anesthesiologists grade and anemia.ConclusionPNI and NLR were independent predictors of OS and PFS for patients with bladder cancer after radical cystectomy and PNI might be a novel reliable biomarker for bladder cancer.