Preoperative High Neutrophil–to–Lymphocyte Ratio Is Associated with High-grade Bladder Cancer

BackgroundInflammation is widely considered an important hallmark of cancer and associated with poor postoperative survival. The objective of this study is to assess the significance of preoperative C-NLR, a new inflammation-based index that includes preoperative C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR), on therapeutic outcomes for bladder cancer (BC) patients after radical cystectomy (RC).Materials and MethodsBC patients who underwent RC between 2010 and 2019 were retrospectively analyzed from our medical center. The predictive effect of CRP, NLR, and C-NLR on the survival of BC patients were analyzed by the receiver operating characteristic (ROC) curves. The relationship between C-NLR and postoperative survival was investigated by Cox regression. The corresponding nomograms were built based on the Cox regression results of overall survival (OS) and disease-free survival (DFS), which were further validated by ROC curves, decision curve analysis (DCA) curves, and calibration curves.ResultsOf the 199 eligible patients, 83 (41.70%) were classified as high C-NLR group and the remaining 116 (58.30%) were classified as low C-NLR group. ROC analysis showed that C-NLR had the largest area under curve (AUC) compared to CRP and NLR. Multivariate analysis revealed that T-stage and C-NLR [high C-NLR vs. low C-NLR, hazard ratio (HR) = 2.478, 95% confidence interval (CI), 1.538–3.993, p < 0.001] were independent predictors of OS, whereas T-stage, M-stage, and C-NLR (high C-NLR vs. low C-NLR, HR = 2.817, 95% CI, 1.667–4.762, p < 0.001) were independent predictors of DFS. ROC and DCA analysis demonstrated better accuracy and discrimination of 3- and 5-year OS and DFS with C-NLR-based nomogram compared to TNM stage. The calibration curve reconfirmed the accurate predicting performance of nomograms.ConclusionC-NLR is a reliable predictor of long-term prognosis of BC patients after RC and will contribute to the optimization of individual therapy for BC patients.

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Preoperative neutrophil to lymphocyte ratio can improve disease progression prediction of non-muscle invasive bladder cancer

Journal of Molecular and Clinical Medicine ◽

10.31083/j.jmcm.2018.03.002 ◽

2018 ◽

Vol 1 (3) ◽

Keyword(s):

Bladder Cancer ◽

Disease Progression ◽

Neutrophil To Lymphocyte Ratio ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Lymphocyte Ratio ◽

Muscle Invasive ◽

Progression Prediction

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Evaluating prognostic utility of preoperative Neutrophil to Lymphocyte Ratio and hsa-let-7g/c up-regulation in patients with urinary bladder cancer

Cancer Biomarkers ◽

10.3233/cbm-190483 ◽

2019 ◽

Vol 27 (1) ◽

pp. 63-73

Author(s):

Nouha Setti Boubaker ◽

Aymone Gurtner ◽

Nesrine Trabelsi ◽

Isabella Manni ◽

Rahma Said ◽

...

Keyword(s):

Bladder Cancer ◽

Urinary Bladder ◽

Urinary Bladder Cancer ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Prognostic Utility

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Prognostic utility of the combination of pretreatment monocyte-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with NMIBC after transurethral resection

Biomarkers in Medicine ◽

10.2217/bmm-2019-0398 ◽

2019 ◽

Vol 13 (18) ◽

pp. 1543-1555

Author(s):

Qinghai Wang ◽

Tao Huang ◽

Jianlei Ji ◽

Hongyang Wang ◽

Chen Guo ◽

...

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Cox Regression ◽

Disease Free Survival ◽

Predictive Biomarker ◽

Neutrophil To Lymphocyte Ratio ◽

Invasive Bladder Cancer ◽

Lymphocyte Ratio ◽

Prognostic Utility ◽

Nonmuscle Invasive Bladder Cancer

Aim: To investigate and validate predictive value of combination of pretreatment monocyte-to-lymphocyte ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR) for disease free survival (DFS) and overall survival (OS) in nonmuscle invasive bladder cancer after transurethral resection. Materials & methods: Total 358 patients enrolled were assigned into three (MLR-NLR 0, 1 and 2) groups per the cut-off values of MLR and NLR. Results: Kaplan–Meier curves showed MLR, NLR and their combination were statistically associated with DFS (p < 0.001) and OS (p < 0.001). Univariate and multivariate COX regression analyses revealed that combination of MLR with NLR was an independent prognostic predictor for both DFS (HR: 3.080; 95% CI: 1.870–5.074; p < 0.001 for MLR-NLR 2 vs MLR-NLR 0) and OS (HR: 2.815; 95% CI: 1.778–4.456; p < 0.001 for MLR-NLR 2 vs MLR-NLR 0). Calibration plots and decision curve analysis exhibited combination of MLR and NLR had good calibration accuracy with potential clinical usefulness. Conclusion: Combined MLR and NLR is a prognostic predictive biomarker in nonmuscle invasive bladder cancer after transurethral resection.

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Elevated neutrophil to lymphocyte and platelet to lymphocyte ratios predict high grade and advanced stage renal cell carcinoma

The International Journal of Biological Markers ◽

10.1177/1724600818817557 ◽

2019 ◽

Vol 34 (1) ◽

pp. 15-19 ◽

Cited By ~ 1

Author(s):

Selahattin Çalışkan

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Blood Test ◽

Neutrophil To Lymphocyte Ratio ◽

Renal Tumors ◽

High Grade ◽

Advanced Stage ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio

Introduction: Renal cell carcinoma is the most common malignancy of the kidney, which accounts 85% of all renal tumors. In recent years, the incidence of renal cell carcinoma was increased due to the widespread use of imaging techniques. The aim of this study is to investigate the clinical significance of pretreatment neutrophil to lymphocyte and platelet to lymphocyte ratios in patients with renal cell carcinomas. Methods: The patients who underwent nephrectomy for renal tumor between 2010 and 2018 in two centers were reviewed retrospectively. The age, sex, complete blood test, and pathological results were recorded. The patients who were diagnosed with other carcinomas, benign renal tumors, and missing data of age, complete blood test, and pathological results, were excluded. The patients were divided into two groups according to the T stage and Fuhrman grade, T1-2 and T3-4, G1-2 and G3-4. Results: There were 271 patients in the current study. The male to female ratio was 1.97 and the mean age of the patients was 59.37±11.62 years. Clear cell renal cell carcinoma was the most common subtype in 72.7% of the patients. Both the neutrophil to lymphocyte ratio and the platelet to lymphocyte ratio were significantly higher in patients with high-grade and advanced-stage disease than in the others. The receiver operating characteristic curve showed no significant difference between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio to diagnose the high grade and stage of renal cell carcinoma. Conclusion: The neutrophil to lymphocyte and platelet to lymphocyte ratios are easily accessible biomarkers which are used for the prognosis of malignancy. The current study found that these biomarkers may predict the pathological results during the preoperative period.

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