摘要
目的 探讨术前临床实验室指标对行腹腔镜下根治性膀胱切除术的肌层浸润性膀胱癌(MIBC)患者术后疗效及预后的影响。方法 回顾性分析该院2013年5月至2016年5月收治的MIBC患者的临床资料,选择择期在腹腔镜下行根治性膀胱切除术的患者69例,收集并记录患者的一般临床资料及实验室血清学相关指标。采用单因素和多因素COX风险回归法分析患者的一般临床资料及实验室血清学相关指标对MIBC患者腹腔镜下膀胱癌根治术后疗效及预后的影响因素,绘制Kaplan-Meier生存曲线比较不同指标评价患者的生存率。结果 年龄、体重指数(BMI)、肿瘤最大径、TNM分期、侵犯淋巴脉管、术后进行放化疗、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、中性粒细胞计数、超敏C反应蛋白(hs-CRP)、中性粒细胞/淋巴细胞比值(NLR)是MIBC患者腹腔镜下根治性膀胱切除术后全因死亡的影响因素(P<0.05);多因素COX风险回归结果显示,年龄、肿瘤最大径、TNM分期、侵犯淋巴脉管、HDL-C及NLR是MIBC患者腹腔镜下根治性膀胱切除术后全因死亡的独立危险因素(P<0.05)。Kaplan-Meier生存曲线分析结果显示,高HDL-C组(HDL-C≥1.2 mmol/L)生存率明显高于低HDL-C组(HDL-C<1.2 mmol/L),高NLR组(NLR≥1.65)生存率明显低于低NLR组(NLR<1.65),差异均有统计学意义(P<0.01)。结论 治疗前临床实验室指标对接受腹腔镜下根治性膀胱切除术MIBC患者预后具有预测价值,可用于筛选及关注高危患者。
Objective To investigate the effect of preoperative clinical laboratory indexes on the postoperative efficacy and prognosis of patients with muscular-invasive bladder cancer(MIBC)underwent laparoscopic radical cystectomy.Methods Clinical data of MIBC patients admitted to our hospital from May 2013 to May 2016 were retrospectively analyzed,and 69 cases of patients underwent laparoscopic radical cystectomy were selected.General clinical data and laboratory serological indicators of patients were collected and recorded.Univariate and multivariate COX risk regression methods were used to analyze the influencing factors of general clinical data and laboratory serological indicators on the curative effect and prognosis of MIBC patients after laparoscopic radical cystectomy,and Kaplan-Meier survival curve was drawn to evaluate the survival rate of different indicators.Results Age,BMI,maximum tumor diameter,TNM stage,invasion of lymphatic vessels,postoperative chemoradiotherapy,total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),neutrophil count,hypersensitive C-reactive protein(hs-CRP),neutrophil to lymphocyte ratio(NLR)were the influencing factors of all-cause mortality after laparoscopic radical cystectomy in MIBC patients(P<0.05).Multivariate COX risk regression results showed that age,maximum tumor diameter,TNM stage,invasion of lymphatic vessels,HDL-C and NLR were independent risk factors for all-cause death after laparoscopic radical cystectomy in MIBC patients(P<0.05).Kaplan-Meier survival curve analysis showed that the survival rate of the high HDL-C group(HDL-C≥1.2 mmol/L)was significantly higher than that of the low HDL-C group(HDL-C<1.2 mmol/L),and the survival rate of the high NLR group(NLR≥1.65)was significantly lower than that of the low NLR group(NLR<1.65),with statistically significant(P<0.01).Conclusion Clinical laboratory indicators before treatment have predictive value for the prognosis of MIBC patients underwnet laparoscopic radical cystectomy,which can be used for screening and fo
作者
符海能
梁培育
王声兴
符津山
FU Haineng;LIANG Peiyu;WANG Shengxing;FU Jinshan(Department of Urology,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570102,China)
出处
《国际检验医学杂志》
CAS
2023年第10期1167-1171,共5页
International Journal of Laboratory Medicine
基金
海南省重点研发计划项目(ZDYF2019122)
海南省自然科学基金项目(20158298)。
