This study aimed to investigate the associations between the preoperative prognostic nutritional index (PNI), systemic immune-inflammation index (SII) and overall survival (OS) and cancer-specific survival (CSS) in high-risk non-muscle-invasive bladder cancer (NMIBC) patients who received intravesical instillation of Bacillus Calmette-Guerin (BCG) after transurethral resection of bladder tumour (TURBT). Patients and Methods: We retrospectively collected data from 387 high-risk NMIBC patients between January 2004 and December 2014. PNI was calculated as total lymphocyte count (10 9 / L)×5+albumin concentration (g/L). SII was calculated as neutrophil count (10 9 /L)×platelet count (10 9 /L)/lymphocyte count (10 9 /L). The cutoff values of PNI and SII were determined through receiver operating characteristic (ROC) analysis. OS and CSS were estimated by Kaplan-Meier analysis. The Log rank test was used to compare differences between the groups. Univariate and multivariate Cox regression analyses were performed to assess the predictive values of PNI and SII for OS and CSS. Additionally, highest-risk NMIBC patients were also divided into low or high groups according to PNI and SII. The OS and CSS of highest-risk NMIBC patients were estimated using Kaplan-Meier analysis with the Log rank test. Results: The patients were divided into two groups according to the cutoff values of PNI (<50.17 vs ≥50.17) and SII (<467.76 vs ≥467.76). Kaplan-Meier analysis revealed that low PNI and high SII were associated with poorer OS and CSS in high-risk NMIBC patients. Univariate and multivariate Cox regression analyses revealed that PNI and SII were independent predictive factors for OS and CSS. Kaplan-Meier analysis also revealed that low PNI and high SII were related to poorer OS and CSS in highest-risk NMIBC patients. Conclusion: These results suggest that preoperative PNI and SII, based on standard laboratory measurements, may be useful noninvasive, inexpensive and simple tools for predicting the longterm survival of high-risk NMIBC patients who received intravesical instillation of BCG after TURBT.

Background Bladder cancer (BC) is the most commonly occurring malignant tumor of the urinary system worldwide. Long non-coding RNAs (lncRNAs), including lncRNA RNF144A-AS1 (RNF144A-AS1), perform an oncogenic role in BC progression. However, how RNF144A-AS1 is regulated in BC has not been fully investigated, and its role in BC is mostly obscure. In this study, we explore its role in BC progression. Materials and Methods The expression level of RNF144A-AS1 in BC tissues was explored via bioinformatics analysis and quantitative real-time PCR (qRT-PCR). We used RNF144A-AS1 siRNA (si-RNF144A-AS1) to inhibit the RNF144A-AS1 level in BC cell lines (J82 and 5637 cells). A series of experimental studies in vitro (CCK-8 assay, colony formation assay and Transwell assay) was performed to explore the role of si-RNF144A-AS1 on the proliferation, migration and invasion of J82 and 5637 cells. A BC xenograft model was established, and the effect of si-RNF144A-AS1 on xenograft growth was explored in vivo. The interactions among RNF144A-AS1, miR-455-5p and SOX11 were predicted by bioinformatics miRanda and Targetscan database, and verified by the luciferase reporter assay and RNA pull-down assay. Finally, miR-455-5p inhibitor and si-RNF144A-AS1 were cotransfected into J82 and 5637 cells. Results RNF144A-AS1 is overexpressed in BC tumors and cells, and its overexpression is correlated with poor prognosis. Knockdown of RNF144A-AS1 markedly suppressed the proliferation, migration and invasion of J82 and 5637 cells and significantly inhibited xenograft growth in nude mice, compared to si-NC. We found that RNF144A-AS1 serves as a sponge for miR-455-5p. Furthermore, a binding site of miR-455-5p was found in 3ʹ UTR of SOX11 gene, and overexpression of miR-455-5p suppressed SOX11 levels. RNF144A-AS1 knockdown markedly decreased SOX11 expression levels, while miR-455-5p inhibitor restored this repressive effect. Restoration of SOX11 could reverse this repressive effect of RNF144A-AS1 on cell proliferation, migration and invasion abilities. Conclusion Overall, our findings underline the critical role of RNF144A-AS1 in BC development, and our study reveals for the first time that RNF144A-AS1 promotes BC progression via the RNF144A-AS1/miR-455-5p/SOX11 axis.

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Background The predictive values of preoperative prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) for long-term recurrence-free survival (RFS) in high-risk non-muscle-invasive bladder cancer (NMIBC) have not been fully elucidated. Hence, this study aimed to examine the associations between PNI and SII as well as RFS in patients with high-risk NMIBC who received intravesical instillation of Bacillus Calmette–Guerin (BCG) after transurethral resection of bladder tumour (TURBT).Methods We retrospectively collected data on 387 high-risk NMIBC patients between January 2004 and December 2014. Preoperative PNI was calculated as albumin concentration (g/L)+5×total lymphocyte count (109/L), while preoperative SII was defined as neutrophil count (109/L)×platelet count (109/L)/lymphocyte count (109/L). The optimal cut-off values of PNI and SII were determined via a receiver operating characteristic analysis. RFS was evaluated via a Kaplan–Meier analysis. Between-group differences were compared using the log-rank test. Univariate and multivariate Cox regression analyses were performed to assess the predictive values of PNI and SII for RFS.Results Patients were divided into two groups according to the cut-off values of PNI (<50.17 vs ≥50.17) and SII (<467.76 vs ≥467.76). Kaplan-Meier analyses revealed that low PNI and high SII were associated with poor RFS in patients with high- and higher-risk NMIBC. Furthermore, based on univariate and multivariate Cox regression analyses, PNI and SII were independent predictive factors of RFS in patients with high-risk NMIBC.Conclusion Preoperative PNI and SII are simple, noninvasive, inexpensive and useful tools for predicting long-term RFS among patients with high-risk NMIBC who received intravesical instillation of BCG after TURBT.