Abstract：
The aim of this study was to investigate the prognostic role of blood-based nutritional biomarkers, including red blood cell (RBC count), hemoglobin (Hb), total protein (TP), albumin, the serum albumin to globulin ratio (AGR) and the prognostic nutritional index (PNI) in patients who underwent intravesical treatment for non-muscle invasive bladder cancer (NMIBC). A total of 501 NMIBC patients who received intravesical Bacillus Calmette-Guerin (BCG) treatment following transurethral resection of bladder tumor (TURBT) were included. The optimal cutoff values for these nutrition-based indicators were determined using receiver operating characteristic curve analysis. We observed a significantly higher recurrence-free survival (RFS) rate in patients with elevated levels of RBC count, Hb, TP, and albumin. Cox univariate and multivariate Cox regression analyses demonstrated that serum albumin (P = 0.002, HR = 0.51, 95%CI: 0.33-0.78), RBC count (P = 0.002, HR = 0.50, 95%CI: 0.32-0.77), TP (P = 0.028, HR = 0.62, 95%CI: 0.41-0.95), Hb (P = 0.004, HR = 0.53, 95%CI: 0.33-0.84), AGR (P = 0.003, HR = 0.46, 95%CI: 0.27-0.76) and PNI (P = 0.019, HR = 0.56, 95%CI: 0.35-0.91) were significant independent factors predicting RFS. These cost-effective and convenient blood-based nutritional biomarkers have the potential to serve as valuable prognostic indicators for predicting recurrence in NMIBC patients undergoing BCG-immunotherapy.
摘要：
这项研究的目的是调查血液营养生物标志物的预后作用，包括红细胞（红细胞计数），血红蛋白（Hb），总蛋白（TP），白蛋白,非肌层浸润性膀胱癌(NMIBC)膀胱内治疗患者的血清白蛋白与球蛋白比值(AGR)和预后营养指数(PNI).共纳入501例经尿道膀胱肿瘤电切术（TURBT）后接受膀胱内卡介苗（BCG）治疗的NMIBC患者。使用受试者工作特征曲线分析确定了这些基于营养的指标的最佳截止值。我们观察到RBC计数水平升高的患者的无复发生存率（RFS）明显更高，Hb,TP,和白蛋白。Cox单因素和多因素Cox回归分析显示血清白蛋白(P=0.002,HR=0.51,95CI:0.33-0.78),红细胞计数（P=0.002，HR=0.50，95CI：0.32-0.77），TP（P=0.028，HR=0.62，95CI：0.41-0.95），Hb（P=0.004，HR=0.53，95CI：0.33-0.84），AGR(P=0.003,HR=0.46,95CI:0.27~0.76)和PNI(P=0.019,HR=0.56,95CI:0.35~0.91)是预测RFS的独立因素。这些具有成本效益且方便的基于血液的营养生物标志物有可能作为预测接受BCG免疫疗法的NMIBC患者复发的有价值的预后指标。
