Objective:
To explore the
efficacy of combining the
prognostic nutritional index (PNI) and the
lymphocytemonocyte ratio (LMR) for
patients with
muscle-invasive
bladder cancer (MIBC).
Methods:
Of 172
patients who were diagnosed with MIBC in our
hospital, 94 were eligible for the study. The clinical data of the 94
patients with MIBC were collected. The
patients were divided according to the optimal cut-off values for the preoperative PNI and LMR into a low-PNI subgroup (PNI <44.15, 52
patients), a high-PNI subgroup (PNI ≥44.15, 42
patients), a low-LMR subgroup (LMR <2.98, 50
patients) and a high-LMR subgroup (LMR ≥2.98, 44
patients). The area under the
receiver operating characteristic (ROC) curve (
AUC) was used to analyse the
efficacy of the PNI and the LMR in predicting the
prognosis of
patients with MIBC. Univariate and multivariate
logistic regression analyses were performed to evaluate
prognostic factors for
patients with MIBC. KaplanMeier (K‒M)
survival analysis was used for overall
survival (OS)
analysis to explore the
ability of the PNI combined with the LMR to predict the
prognosis of
patients with MIBC.
Results:
The optimal cut-off values for the preoperative PNI and the preoperative LMR were 44.15 and 2.98, respectively, on the basis of
ROC curves.
ROC curve analysis revealed that the PNI (
AUC = 0.720,
sensitivity 65.9%,
specificity 74.50%, Youden index 0.399) and the LMR (
AUC = 0.724,
sensitivity 65.9%,
specificity 70.0%, Youden index 0.395) both had good prognostic
efficacy for
patients with MIBC. The results of univariate and multivariate
logistic regression analyses showed that preoperative PNI <44.15 was an independent
risk factor for OS in
patients with MIBC (p = 0.027). Based on K‒M
survival curve
analysis,
patients with PNI <44.15 and LMR <2.98 had the shortest OS (p = 0.00002).
Conclusions:
Low preoperative PNI and LMR values are indicative of poor
prognosis in
patients with MIBC...(AU)