The predictive value of the ratio of the product of neutrophils and hemoglobin to lymphocytes in non‐muscular invasive bladder cancer patients with postoperative recurrence

Abstract

Purpose The purpose of this study was to explore the predictive value of the ratio of the product of neutrophils and hemoglobin to lymphocytes (NHL) in patients with non‐muscular invasive bladder cancer (NMIBC). Materials and Methods We retrospectively collected clinical and pathological data of patients with NMIBC who underwent transurethral resection of bladder tumor (TURBT) at our hospital between 2013 and 2018. The ratio of neutrophils to lymphocytes (NLR), the Systemic Immune Inflammation Index (SII), and NHL were obtained based on routine blood settlement within a week before surgery. The receiver operating characteristic curve was used to determine the optimal cutoff value of each index, and different groups were grouped accordingly. Kaplan‐Meier survival curve and Cox regression model were used to study the factors affecting the prognosis of NMIBC patients. Results There was significant difference in recurrence‐free survival (RFS) rate between the high NLR group and the low NLR group, the high SII group and the low SII group, and the high NHL group and the low NHL group. Cox univariate regression analysis showed that tumor number, tumor size, tumor pathological grade, tumor pathological stage, NLR, SII, and NHL were related to postoperative RFS in patients with NMIBC. The tumor number, tumor pathological grade, SII, and NHL were independent predictors of RFS in multivariate analysis. Conclusions The preoperative clinical inflammatory indexes NLR, SII, and NHL have certain predictive value for postoperative RFS in NMIBC patients.

The Prognostic and Clinicopathological Significance of Systemic Immune-Inflammation Index in Bladder Cancer

“…Full texts of 17 studies were then reviewed, with 7 studies excluded. Finally, 10 studies that comprised 7,087 patients were included in this meta-analysis ( 9 – 13 , 16 – 20 ). All the included studies have been published within the last 3 years (2019–2021); five studies focused on NMIBC ( 11 , 16 , 17 , 19 , 20 ) and the other five studies on MIBC ( 9 , 10 , 12 , 13 , 18 ).…”

“…Finally, 10 studies that comprised 7,087 patients were included in this meta-analysis ( 9 – 13 , 16 – 20 ). All the included studies have been published within the last 3 years (2019–2021); five studies focused on NMIBC ( 11 , 16 , 17 , 19 , 20 ) and the other five studies on MIBC ( 9 , 10 , 12 , 13 , 18 ). Notably, all of the 10 studies were retrospective, and six of them had been conducted in China ( 9 , 11 , 12 , 16 , 19 , 20 ), two in Europe and United States ( 10 , 17 ), one in Turkey ( 13 ), and one in Japan ( 18 ).…”

“…All the included studies have been published within the last 3 years (2019–2021); five studies focused on NMIBC ( 11 , 16 , 17 , 19 , 20 ) and the other five studies on MIBC ( 9 , 10 , 12 , 13 , 18 ). Notably, all of the 10 studies were retrospective, and six of them had been conducted in China ( 9 , 11 , 12 , 16 , 19 , 20 ), two in Europe and United States ( 10 , 17 ), one in Turkey ( 13 ), and one in Japan ( 18 ). The sample size in the included studies ranged from 79 to 4,335 patients, with the median patient age ranging from 53.6 to 73 years, and the cutoff values of SII ranged from 276 to 896.…”

Can Routine Blood and Urine Parameters Reveal Clues to Detect Bladder Cancer? A Case–Control Study

“…For example, it was reported that a higher NLR was associated with an increased risk of disease recurrence and progression in patients with bladder cancer (21,22). Zhao et al indicated that tumor tissue stimulated the production of neutrophils, which could promote tumor cell proliferation and angiogenesis by releasing cytokines and effector molecules, especially interleukins and the pro-angiogenic vascular endothelial growth factor (23). Meanwhile, a decreased lymphocyte level could weaken adaptive immune responses towards the tumor.…”

“…Meanwhile, a decreased lymphocyte level could weaken adaptive immune responses towards the tumor. The combined effects of these two cellular mechanisms indicated that the NLR reflected the results of antagonism between inflammatory responses and antitumor effects and therefore had a certain prognostic value for tumors (23). Blood cell count is routinely tested for hospitalized patients, so it required no additional cost or patient inconvenience (22).…”