Can High Preoperative Neutrophil-lymphocyte Ratio Predict the Recurrence and Progression Risk of Non-muscle-invasive Bladder Tumors?

Abstract

Neutrophil-lymphocyte ratio (NLR) is a well-known, cost-effective biomarker of inflammatory conditions, and its protumor effect has been shown in different types of cancers. In this study, we aimed to evaluate the relationship between blood parameters, especially NLR, with the risk of progression and recurrence in non-muscle-invasive bladder tumors (NMIBT). Materials and Methods: Seventy-six patients were included in the study. Patients were divided into low, moderate and high-risk groups according to the risk of progression and recurrence. The preoperative blood parameters of the patients were recorded from the patient files and the NLR of each patient was calculated. These parameters were compared in terms of progression and recurrence risk groups. P values less than 0.05 were accepted statistically significant. Results: Neutrophil-lymphocyte ratio was significantly higher in the high-risk group in both the progression and recurrence risk groups than in the low and moderate risk groups (p<0.001). In addition, according to the post hoc results, the NLR values in the high-moderate and moderate-low risk groups showed significant differences (high-moderate and moderate-low values in terms of risk of recurrence were 4.66 vs 3.67 and 3.67 vs 2.88, respectively, p<0.001; high-moderate and moderate-low values in terms of risk of progression were 4.72 vs 3.68 and 3.68 vs 2.92, respectively, p<0.001). Conclusion: In our study, we found that groups with high risk of recurrence and progression had higher NLR values in patients with NMIBT. NLR, which is cheap, rapid and routinely applied in preoperative evaluation, is a promising biomarker in the prognostic classification of bladder tumors. Well-designed, large-scale prospective studies with long-term follow-up are needed to determine the role of NLR in this issue.