| 袁 帅,毕 兴,牛 越,冯富鹏,毛 莉,张 荣.术前预后营养指数联合血清CXCL5、YKL-40对非肌层浸润性膀胱癌患者经尿道膀胱肿瘤电切术后复发的预测价值[J].,2022,(20):3912-3916 |
| 术前预后营养指数联合血清CXCL5、YKL-40对非肌层浸润性膀胱癌患者经尿道膀胱肿瘤电切术后复发的预测价值 |
| Predictive Value of Preoperative Prognostic Nutritional Index Combined with Serum CXCL5 and YKL-40 for Recurrence after Transurethral Resection of Bladder Tumor of Non-Muscular Invasive Bladder Cancer |
| 投稿时间：2022-03-27 修订日期：2022-04-23 |
| DOI：10.13241/j.cnki.pmb.2022.20.022 |
| 中文关键词: 非肌层浸润性膀胱癌 经尿道膀胱肿瘤电切术 复发 预后营养指数 CXCL5 YKL-40 预测价值 |
| 英文关键词: Non-muscular invasive bladder cancer Transurethral resection of bladder tumor Recurrence Prognostic nutritional index CXCL5 YKL-40 Predictive value |
| 基金项目:吴阶平医学基金会临床科研专项资助基金项目（320.6750.19088-42） |
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| 中文摘要: |
| 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。 |
| 英文摘要: |
| ABSTRACT 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%, 97.40%, 59.74%, 79.22%, respectively. Preoperative PNI combined with serum CXCL5 and YKL-40 levels predicted the AUC of recurrence after TUR-BT in patients with NMIBC was greater than that predicted by the three alone (P＜0.05). Conclusion: The increased serum CXCL5 and YKL-40 levels are independent risk factors for recurrence after TUR-BT in patients with NMIBC, and increased preoperative PNI is an independent protective factor. Combined detection of the three has a high predictive value for recurrence after TUR-BT in patients with NMIBC. |
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