Skip to main content

Advertisement

SpringerLink
Log in

Bladder cancer invasion predictability based on preoperative neutrophil–lymphocyte ratio

  • Research Article
  • Published:
Tumor Biology

Abstract

An increased pretreatment neutrophil–lymphocyte ratio (NLR) is associated with poor prognosis in colorectal, gastric, and ovarian cancer; malignant mesothelioma; and renal cell carcinoma. The present study aims to define the predictive value of preoperative peripheral blood count NLR in non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive disease (MIBC) patients. There were in total 291 patients, 241 males and 50 females. Out of these, 156 male and 36 female patients were in the NMIBC group and 85 male and 14 female patients in the MIBC group. In the NMIBC group, 172 patients had low-grade and 20 high-grade papillary urothelial carcinoma. The mean age of the patients in the NMIBC group was 64 ± 13, ranging from 27 to 97. The mean age of the patients in MIBC group was 70.5 ± 10, ranging from 27 to 95. A statistically significant relation between patient ages and tumor invasiveness was determined (p = 0.023, 95 % confidence interval (CI) 63.3–66.7). The mean tumor size of the NMIBC group was 2.1 ± 1.09 (cm) (range 0.5–8), and of MIBC group 3.6 ± 1.5 (cm) (range 0.8–9). There was a statistically significant relation between the tumor size and invasiveness (p = 0.002, 95 % CI 2.8–4.4). In the NIMBC group, 149 (77.6 %) of them have NLR ≤ 2.5 and 43 (22.4 %) have NLR > 2.5. Also, in MIBC, 67 (67.7 %) of them have NLR ≤ 2.5 and 32 (32.3 %) have NLR > 2.5. The mean NLR in the NMIBC group was 2.4 ± 0.1 (range 0.08–6.49, 95 % CI 1.52–2.71) and in the MIBC 2.9 ± 0.2 (range 0.08–16.72, 95 % CI 1.67–2.97). In terms of NLR, there was a statistically significant difference between the NMIBC and MIBC groups (p = 0.028). Platelet–lymphocyte ratio (PLR) of the two groups was also analyzed. The PLR of the NMIBC group was 12.8 ± 15.1 (range 3.38–19.1) and of the MIBC 13.6 ± 8.78 (range 0.18–63), yet there was not any statistically significant difference (p = 0.810, 95 % CI 11.4–14.8) (Table 1). The correlation tests revealed a positive correlation between the age (r = 0.144, p = 0.024), tumor size (r = 0.193, p = 0.02), and tumor invasiveness NLR (r = 0.138, p = 0.031). NLR can be used to determine tumor invasiveness as a cost-effective, common, and simple biomarker in bladder cancer (BC).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Witjes JA, Compérat E, Cowan NC, De Santis M, Gakis G, Lebret T el al. Guidelines on muscle-invasive and metastatic bladder cancer. EAU Guideline 2013;1-82.

  2. Sobin LH, Gospodariwicz M, Wittekind C, editors. TNM classification of malignant tumors. UICC International Union Against Cancer, ed. 7. Hoboken: Wiley-Blackwell; 2009. p. 262–5.

  3. Van Rhijn BW, van der Poel HG, van der Kwast TH. Urine markers for bladder cancer surveillance: a systematic review. Eur Urol. 2005;47(6):736–48.

    Article  PubMed  Google Scholar 

  4. Zahorec R. Ratio of neutrophil to lymphocyte counts—rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5–14.

    CAS  PubMed  Google Scholar 

  5. Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010;6(1):149–63.

    Article  CAS  PubMed  Google Scholar 

  6. Clarke SJ, Chua W, Moore M, Kao S, Phan V, Tan C, et al. Use of inflammatory markers to guide cancer treatment. Clin Pharmacol Ther. 2011;90(3):475–8.

    Article  CAS  PubMed  Google Scholar 

  7. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005;91(3):181–4.

    Article  CAS  PubMed  Google Scholar 

  8. Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, et al. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2009;58(1):15–23.

    Article  CAS  PubMed  Google Scholar 

  9. Kao SC, Pavlakis N, Harvie R, Vardy JL, Boyer MJ, van Zandwijk N, et al. High blood neutrophil-to-lymphocyte ratio is an indicator of poor prognosis in malignant mesothelioma patients undergoing systemic therapy. Clin Cancer Res. 2010;16(23):5805–13.

    Article  CAS  PubMed  Google Scholar 

  10. Ohno Y, Nakashima J, Ohori M, Hatano T, Tachibana M. Pretreatment neutrophil-to-lymphocyte ratio as an independent predictor of recurrence in patients with nonmetastatic renal cell carcinoma. J Urol. 2010;184(3):873–8.

    Article  PubMed  Google Scholar 

  11. Babjuk M, Burger M, Zigeuner R, Shariat SF, van Rhijn BW, Compérat E, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2013. Eur Urol. 2013;64(4):639–53.

    Article  PubMed  Google Scholar 

  12. De Boer EC, De Jong WH, Steerenberg PA, Aarden LA, Tetteroo E, De Groot ER, et al. Induction of urinary interleukin-1 (IL-1), IL-2, IL-6, and tumour necrosis factor during intravesical immunotherapy with bacillus Calmette-Guérin in superficial bladder cancer. Cancer Immunol Immunother. 1992;34(5):306–12.

    Article  PubMed  Google Scholar 

  13. Taniguchi K, Koga S, Nishikido M, Yamashita S, Sakuragi T, Kanetake H, et al. Systemic immune response after intravesical instillation of bacille Calmette-Guérin (BCG) for superficial bladder cancer. Clin Exp Immunol. 1999;115(1):131–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883–99.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Tachibana M, Miyakawa A, Tazaki H, Nakamura K, Kubo A, Hata J, et al. Autocrine growth of transitional cell carcinoma of the bladder induced by granulocyte-colony stimulating factor. Cancer Res. 1995;55(15):3438–43.

    CAS  PubMed  Google Scholar 

  17. Gondo T, Nakashima J, Ohno Y, Choichiro O, Horiguchi Y, Namiki K, et al. Prognostic value of neutrophil-to-lymphocyte ratio and establishment of novel preoperative risk stratification model in bladder cancer patients treated with radical cystectomy. Urology. 2012;79(5):1085–91.

    Article  PubMed  Google Scholar 

  18. de Martino M, Pantuck AJ, Hofbauer S, Waldert M, Shariat SF, Belldegrun AS, et al. Prognostic impact of preoperative neutrophil-to-lymphocyte ratio in localized nonclear cell renal cell carcinoma. J Urol. 2013;190(6):1999–2004.

    Article  PubMed  Google Scholar 

  19. Dalpiaz O, Ehrlich GC, Mannweiler S, Hernández JM, Gerger A, Stojakovic T, et al. Validation of pretreatment neutrophil-lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma. BJU Int. 2013. doi:10.1111/bju.12441.

    Google Scholar 

  20. Bircan S, Candir O, Kapucuoglu N. The effect of tumor invasion patterns on pathologic stage of bladder urothelial carcinomas. Pathol Oncol Res. 2005;11(2):87–91.

    Article  PubMed  Google Scholar 

  21. Can C, Baseskioglu B, Yılmaz M, Colak E, Ozen A, Yenilmez A. Pretreatment parameters obtained from peripheral blood sample predicts invasiveness of bladder carcinoma. Urol Int. 2012;89(4):468–72.

    Article  CAS  PubMed  Google Scholar 

  22. Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012;23(4):265–73.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Azuma T, Matayoshi Y, Odani K, Sato Y, Sato Y, Nagase Y, et al. Preoperative neutrophil-lymphocyte ratio as an independent prognostic marker for patients with upper urinary tract urothelial carcinoma. Clin Genitourin Cancer. 2013;11(3):337–41.

    Article  PubMed  Google Scholar 

  24. Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013;88(1):218–30.

    Article  PubMed  Google Scholar 

  25. Schiffer E, Vlahou A, Petrolekas A, Stravodimos K, Tauber R, Geschwend JE, et al. Prediction of muscle-invasive bladder cancer using urinary proteomics. Clin Cancer Res. 2009;15(15):4935–43.

    Google Scholar 

  26. Thrasher JB, Frazier HA, Robertson JE, Dodge RK, Paulson DF. Clinical variables which serve as predictors of cancer-specific survival among patients treated with radical cystectomy for transitional cell carcinoma of the bladder and prostate. Cancer. 1994;73(6):1708–15.

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Urology, Faculty of Medicine, Selcuk University, Konya, Turkey

    Mehmet Kaynar

  2. Department of Urology, Faculty of Medicine, Turgut Özal University, Ankara, Turkey

    Mehmet Erol Yıldırım, Hüseyin Badem, Mücahit Çaviş, Ömer Faruk Karataş & Ersin Çimentepe

  3. Department of Urology, Konya Education and Research Hospital, Konya, Turkey

    Erdem Tekinarslan

  4. Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey

    Mustafa Okan İstanbulluoğlu

Authors
  1. Mehmet Kaynar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehmet Erol Yıldırım
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hüseyin Badem
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mücahit Çaviş
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Erdem Tekinarslan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mustafa Okan İstanbulluoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ömer Faruk Karataş
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ersin Çimentepe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mehmet Kaynar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kaynar, M., Yıldırım, M.E., Badem, H. et al. Bladder cancer invasion predictability based on preoperative neutrophil–lymphocyte ratio. Tumor Biol. 35, 6601–6605 (2014). https://doi.org/10.1007/s13277-014-1889-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13277-014-1889-x

Keywords

Search

Navigation