术前ALI与行根治性膀胱切除术患者预后的关系

The relationship between preoperative ALI and prognosis of patients undergoing radical cystectomy

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摘要目的:探讨晚期肺癌炎症指数(advanced lung cancer inflammatory index,ALI)与行根治性膀胱切除术(radical cystectomy,RC)患者预后的相关性。方法:分析2012年04月至2021年03月在我院住院行根治性膀胱切除术的115例患者的临床资料,包括基本信息、术前血液学检验、组织病理学及生存情况。采用ROC曲线确定ALI最佳临界值(29.49)并将患者分为低ALI组(46例)和高ALI组(69例),通过Kaplan-Meier法建立生存曲线,Log-Rank检验进行患者总生存期(overall survival,OS)组间比较,Cox回归分析行根治性膀胱切除术患者预后影响因素。结果:共纳入115例患者,男(103例),女(12例);T1期(47例),>T1期(68例);病理级别≤G2(38例),G3(77例);N0期(106例),>N0期(9例)。单因素分析表明ALI、T分期、肿瘤病理级别、N分期、中性粒-淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、白细胞及中性粒细胞与OS有关,Wald值分别为25.504、22.458、20.013、15.779、22.645、6.098、14.137,均P<0.05。多因素分析表明低ALI(HR=2.387,95%CI为1.085~5.236,Wald=4.673,P<0.05)、T分期(HR=2.796,95%CI为1.381~5.662,Wald=8.163,P<0.01)和肿瘤病理级别(HR=2.907,95%CI为1.315~6.427,Wald=6.949,P<0.01)是患者OS的独立危险因素。术前低ALI组和高ALI组患者中位OS分别为14个月和>50个月,低ALI组患者OS明显低于高ALI组,差异有统计学意义,χ^(2)=29.825,P<0.01。结论:术前低ALI是行根治性膀胱切除术患者OS的独立危险因素,术前ALI可作为行根治性膀胱切除术患者新的预后评估指标。 Objective:To explore the correlation between the advanced lung cancer inflammatory index(ALI)and the prognosis of patients undergoing radical cystectomy(RC).Methods:To analyze the clinical data of 115 patients who underwent radical cystectomy in our hospital from April 2012 to March 2021,including basic information,preoperative hematology examination,histopathology and survival.The receiver operating characteristic was used to determine the optimal threshold value of ALI(29.49)and the patients were divided into low ALI group(46 cases)and high ALI group(69 cases).The survival curve was established by Kaplan Meier method.Log Rank test was used to compare the overall survival(OS)of patients between groups.Cox regression analysis was used to analyze the prognostic factors of patients undergoing radical cystectomy.Results:A total of 115 patients were included,including 103 males and 12 females.T 1 phase(47 cases),>T 1 phase(68 cases).Pathological grade≤G 2(38 cases),G 3(77 cases).N 0 stage(106 cases),>N 0 stage(9 cases).Univariate analysis showed that ALI,T stage,tumor pathological grade,N stage,neutrophil-to-lymphocyte ratio(NLR),white blood cells,and neutrophils were associated with OS,with Wald values of 25.504,22.458,20.013,15.779,22.645,6.098,and 14.137,respectively,all P<0.05.Multivariate analysis showed that low ALI(HR=2.387,95%CI 1.085~5.236,Wald=4.673,P<0.05),T stage(HR=2.796,95%CI 1.381~5.662,Wald=8.163,P<0.01),and tumor pathological grade(HR=2.907,95%CI 1.315~6.427,Wald=6.949,P<0.01)were independent risk factors for patient OS.The median OS of patients in the low ALI group and high ALI group before surgery was 14 months and>50 months,respectively.The OS of patients in the low ALI group was significantly lower than that in the high ALI group,and the difference was statistically significant(χ^(2)=29.825,P<0.01).Conclusion:Preoperative low ALI is an independent risk factor for OS in patients undergoing radical cystectomy,and preoperative ALI can serve as a new prognostic indicator for patients undergoing ra

作者杨浩魏微阳周川鹏王奇黄红星黄亚强 YANG Hao;WEI Weiyang;ZHOU Chuanpeng;WANG Qi;HUANG Hongxing;HUANG Yaqiang(Department of Urology Surgery,Zhongshan People's Hospital,Guangdong Zhongshan 528499,China)

机构地区中山市人民医院泌尿外科

出处《现代肿瘤医学》 CAS 2024年第4期720-723,共4页 Journal of Modern Oncology

基金广东省中山市科技计划项目(编号:2019B1062,2019B1063)。

关键词膀胱癌根治性膀胱切除术晚期肺癌炎症指数预后 bladder cancer radical cystectomy advanced lung cancer inflammation index prognosis

分类号 R737.14 [医药卫生—肿瘤]