摘要
目的:探讨术前预后营养指数(PNI)联合血清C-X-C基序趋化因子配体5(CXCL5)、壳多糖酶3样蛋白1(YKL-40)对非肌层浸润性膀胱癌(NMIBC)患者经尿道膀胱肿瘤电切术(TUR-BT)后复发的预测价值。方法:选取2019年1月~2021年1月新疆医科大学附属肿瘤医院收治的109例接受TUR-BT治疗的NMIBC患者,根据是否TUR-BT后复发分为复发组(n=32)和未复发组(n=77),比较两组患者临床资料、术前PNI、CXCL5及YKL-40水平。采用单因素和多因素Logistic回归分析NMIBC患者TUR-BT后复发的影响因素。受试者工作特征(ROC)曲线分析术前PNI和血清CXCL5、YKL-40水平对NMIBC患者TUR-BT后复发的预测价值。结果:随访3年,109例NMIBC患者TUR-BT后复发32例,复发率为29.36%。复发组多发肿瘤、肿瘤T1期、低分化比例和血清CXCL5、YKL-40水平高于未复发组,白蛋白、淋巴细胞计数、术前PNI水平低于未复发组(P<0.05)。多因素Logistic回归分析显示,多发肿瘤、肿瘤T1期、低分化肿瘤、血清CXCL5升高、YKL-40升高为NMIBC患者TUR-BT后复发的独立危险因素,术前PNI升高为独立保护因素(P<0.05)。ROC曲线分析显示,术前PNI和血清CXCL5、YKL-40水平单独与联合预测NMIBC患者TUR-BT后复发的曲线下面积(AUC)分别为0.781、0.792、0.780、0.955,灵敏度分别为78.12%、53.13%、84.37%、96.87%,特异度分别为74.03%、97.40%、59.74%、79.22%。术前PNI联合血清CXCL5、YKL-40水平预测NMIBC患者TUR-BT后复发的AUC大于三者单独预测(P<0.05)。结论:血清CXCL5、YKL-40水平升高是NMIBC患者TUR-BT后复发的独立危险因素,术前PNI升高为独立保护因素,三者联合检测对NMIBC患者TUR-BT后复发的预测价值较高。
Objective:To investigate the predictive value of preoperative prognostic nutritional index(PNI)combined with serum C-X-C motif chemokine ligand 5(CXCL5)and chitinase-3-like protein 1(YKL-40)in patients with non-muscular invasive bladder cancer(NMIBC)for recurrence after transurethral resection of bladder tumor(TUR-BT).Methods:A total of 109 patients with NMIBC who were treated with TUR-BT from January 2019 to January 2021 in Cancer Hospital Affiliated to Xinjiang Medical University were selected,and they were divided into recurrence group(n=32)and non-recurrence group(n=77)according to whether there was recurrence after TUR-BT.The clinical data,preoperative PNI,CXCL5 and YKL-40 levels of the two groups were compared.Univariate and multivariate Logistic regression were used to analyze the influencing factors of recurrence after TUR-BT in patients with NMIBC.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of preoperative PNI and serum CXCL5 and YKL-40 levels for recurrence after TUR-BT in patients with NMIBC.Results:After 3 years of follow-up,32 of 109 patients with NMIBC had recurrence after TUR-BT,the recurrence rate was 29.36%.Multiple tumors,tumors T1 stage,low differentiation ratio and serum CXCL5 and YKL-40 levels in the recurrence group were higher than those in the non-recurrence group,while albumin,lymphocyte count and preoperative PNI levels were lower than those in the non-recurrence group(P<0.05).Multivariate Logistic regression analysis showed that multiple tumors,tumors T1 stage,low differentiation tumors,increased serum CXCL5 and increased YKL-40 were independent risk factors for recurrence after TUR-BT in patients with NMIBC,while increased preoperative PNI was independent protective factor(P<0.05).ROC curve analysis showed that preoperative PNI and serum CXCL5 and YKL-40 levels were 0.781,0.792,0.780 and 0.955 respectively for predicting recurrence after TUR-BT in patients with NMIBC.The sensitivity was 78.12%,53.13%,84.37%,96.87%,and the specificity was 74.03%,
作者
袁帅
毕兴
牛越
冯富鹏
毛莉
张荣
YUAN Shuai;BI Xing;NIU Yue;FENG Fu-peng;MAO Li;ZHANG Rong(Department of Urology,Cancer Hospital Affiliated to Xinjiang Medical University,Urumqi,Xinjiang,830011,China)
出处
《现代生物医学进展》
CAS
2022年第20期3912-3916,3940,共6页
Progress in Modern Biomedicine
基金
吴阶平医学基金会临床科研专项资助基金项目(320.6750.19088-42)。
