Predictive value of prognostic nutritional index and systemic immune-inflammation index on tumor progression in bladder cancer patients after radical cystectomy / 国际外科学杂志

ABSTRACT

Objective:To explore the predictive value of preoperative prognostic nutritional index(PNI) and systemic immune-inflammation index(SII) for local tumor stage in bladder cancer after radical cystectomy(RC).Methods:This study is a retrospective study, collecting information on 195 patients with bladder cancer who underwent RC at the Second Hospital of Tianjin Medical University from April 2011 to October 2019. Extract the patient’s preoperative laboratory examination and calculate the PNI and SII. The calculation formula was PNI=albumin (g/L)+ 5×total lymphocyte count (10 9/L); SII=platelets×neutrophils/lymphocytes . Univariate and multivariate Cox regression analysis were used to analyze whether PNI and SII can be used as predictors of muscular invasive bladder cancer(MIBC) and non-muscular invasive bladder cancer(NMIBC). Continuous variables were expressed as mean±standard deviation ( Mean± SD), and t-test was used for comparison between groups; Chi-square test was used for comparison of categorical variables between groups. Generate receiver operating characteristic curve (ROC), calculate area under the curve (AUC) to judge the predictive ability of PNI and SII scoring indicators. The larger of AUC, the stronger the predictive ability. Univariate and multivariate Cox regression analysis were used to calculate the corresponding odds ratio ( OR) and 95% CI. Results:All patients were males, with a mean age of (67.94±8.97) years. Mean serum albumin was (42.13±4.28) g/L, mean PNI was 51.29±6.09 and mean SII was 661.67±506.22. Univariate Cox regression analysis showed that both PNI and SII had statistical significance for the incidence of MIBC; multivariate Cox regression analysis showed that PNI and SII could not be used as the diagnosis of MIBC and NMIBC. PNI was an independent risk factor for predicting tumor stage (pT<3a and pT≥3a).Conclusion:The low preoperative PNI can be used as an independent factor for predicting poor pathological stage (pT≥3a).