Significance Of Systemic Immune Inflammatory Index In Diagnosis And Treatment Of Patients With Bladder Urothelial Carcinoma

Objective:To investigate the significance of systemic immune-inflammatory index（SII）in diagnosis and treatment of patients with bladder urothelial carcinoma Method:A retrospective study was conducted on the clinical data of 154 patients with bladder cancer who first visited our hospital from September 2014 to September 2017.Among them,119 patients who underwent transurethral resection of bladder tumor（TURBT）were selected as NMIBC group;35patients who underwent radical cystectomy（RC）+ urinary diversion were selected as MIBC group.At the same time,100 healthy subjects in our hospital were randomly selected as the control group,and this group was set as the normal physical examination group.SPSS26.0 was applied and the relevant data were statistically analyzed,the preoperative SII values of the three groups were compared,and the receiver operating characteristic curve（Roc）was drawn according to whether tumor recurrence occurred in the NMIBC group and MIBC group after operation.The clinicopathological characteristics of patients with different stages of bladder cancer were compared by the optimal cutoff value of preoperative SII,and whether the preoperative SII value could be used as an indicator for the prognosis of patients with different stages of bladder cancer.Result:There were differences in the SII values among the healthy people,NMIBC patients and MIBC patients（P<0.05）.In NMIBC patients,the high SII group（SII ≥ 370.35）and the low SII group（SII < 370.35）had differences in tumor size,tumor number and postoperative tumor recurrence（P<0.05）.The multivariate Cox regression analysis showed that : Multiple tumors（HR=1.94,95%CI:1.06-3.551,P=0.032）,tumors ≥3cm（HR=1.86,95%CI:1.048-3.3,P=0.034）,high-grade tumors（HR=1.777,95%CI:1.035-3.052,P=0.037）and SII≥370.35（HR=1.955,95%CI:1.051-3.638,P=0.034）were independent risk factors for postoperative RFS in NMIBC patients.Among MIBC patients,there was a difference in tumor stage between the high SII group（SII≥687.26）and the low SII group（SII<687.26）（P<0.05）.Multivariate Cox regression analysis showed that pathological T3 stage（HR=3.237,95%CI:1.074-9.752,P=0.037）,high-grade tumors（HR=6.178,95%CI:1.345-28.384,P=0.019）and SII≥687.26（HR=3.656,95%CI:1.006-13.282,P=0.049）was an independent risk factor for RFS in MIBC patients.Conclusion:1.SII is different in normal healthy people,patients with non-invasive and invasive bladder cancer,and has certain diagnostic value for the depth of invasion of bladder urothelial carcinoma.2.SII value is an independent prognostic factor for NMIBC patients and MIBC patients.High SII indicates poor prognosis and can be used as a prognostic indicator for bladder cancer patients with different stages.3.The SII value is easy to calculate,and the economic cost is low,which is convenient for detection.