A nomogram based on preoperative NLR predicts distant metastasis of urothelial carcinoma of the bladder.

IF 2.2 4区 医学 Q3 ONCOLOGY
Cancer Biomarkers Pub Date : 2024-12-01 Epub Date: 2025-03-17 DOI:10.1177/18758592241296279
Xingxing Zhang, Bin Zhang, Yang He, Wei Xiong, Yuelin Du, Panfeng Shang
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引用次数: 0

Abstract

BackgroundDistant metastasis (DM) remains the most commonly reported cause of death in patients with urothelial carcinoma of the bladder (UCB).ObjectiveWe aimed to develop a robust prognostic model to assess the risk of DM in patients with UCB.MethodsWe collected clinical data of 206 UCB patients treated with RC. Patients treated with RC between 2011-2015 that were enrolled as the training cohort (n = 105), while the patients between 2016-2019 were enrolled as the validation cohort (n = 101). Univariate and multivariate Cox regression models were used to identify independent risk factors associated with DM. We identified the variables by stepwise regression and established nomogram. We evaluated the nomograms using C-index, calibration and ROC curves. Decision curve analysis was performed to compare the net benefits between the nomogram and TNM staging. We divided the patients into high and low risk groups according to the nomogram and compared the DM between the groups.ResultsThe neutrophil-lymphocyte ratio (NLR) was an independent predictor of DM. We established nomogram by T-stage, N-stage and NLR. The C-index of the nomogram was 0.766 and 0.739 respectively in the two cohorts. In the training cohort, AUC for the nomogram at 1, 2 and 3 years was 0.816, 0.812 and 0.812, respectively. In the validation cohort, the AUC for the nomogram at 1, 2 and 3 years was 0.751, 0.757 and 0.716, respectively. The calibration curve was satisfactory. The nomogram has a higher clinical benefit compared to the TNM staging system. Kaplan-Meier curves showed that patients from the high-risk group had a higher probability of DM than patients from the low-risk group.ConclusionsNomograms established by NLR, T-stage and N-stage can accurately predict distant metastases in patients with UCB.

基于术前NLR的形态图预测膀胱尿路上皮癌的远处转移。
背景:远处转移(DM)仍然是膀胱尿路上皮癌(UCB)患者最常见的死亡原因。目的:我们旨在建立一个可靠的预后模型来评估UCB患者发生糖尿病的风险。方法收集206例UCB患者的临床资料。2011-2015年接受RC治疗的患者被纳入训练队列(n = 105),而2016-2019年的患者被纳入验证队列(n = 101)。采用单因素和多因素Cox回归模型确定与糖尿病相关的独立危险因素。我们通过逐步回归确定变量并建立nomogram。我们使用c指数、校准和ROC曲线来评估nomogram。采用决策曲线分析比较nomogram和TNM分期的净收益。根据nomogram将患者分为高危组和低危组,比较两组间的DM。结果中性粒细胞淋巴细胞比(NLR)是糖尿病的独立预测因子,并建立了t期、n期和NLR的关系图。两个队列的nomogram C-index分别为0.766和0.739。在培训队列中,1年、2年和3年nomogram AUC分别为0.816、0.812和0.812。在验证队列中,1年、2年和3年nomogram AUC分别为0.751、0.757和0.716。标定曲线令人满意。与TNM分期系统相比,nomogram分期系统具有更高的临床疗效。Kaplan-Meier曲线显示,高危组患者发生DM的概率高于低危组患者。结论NLR、t分期和n分期建立的x线图能准确预测UCB患者的远处转移。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cancer Biomarkers
Cancer Biomarkers ONCOLOGY-
CiteScore
5.20
自引率
3.20%
发文量
195
审稿时长
3 months
期刊介绍: Concentrating on molecular biomarkers in cancer research, Cancer Biomarkers publishes original research findings (and reviews solicited by the editor) on the subject of the identification of markers associated with the disease processes whether or not they are an integral part of the pathological lesion. The disease markers may include, but are not limited to, genomic, epigenomic, proteomics, cellular and morphologic, and genetic factors predisposing to the disease or indicating the occurrence of the disease. Manuscripts on these factors or biomarkers, either in altered forms, abnormal concentrations or with abnormal tissue distribution leading to disease causation will be accepted.
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