1
|
Barone B, Napolitano L, Reccia P, De Luca L, Morra S, Turco C, Melchionna A, Caputo VF, Cirillo L, Fusco GM, Mastrangelo F, Calace FP, Amicuzi U, Morgera V, Romano L, Trivellato M, Mattiello G, Sicignano E, Passaro F, Ferretti G, Giampaglia G, Capone F, Manfredi C, Crocetto F. Preoperative Fibrinogen-to-Albumin Ratio as Potential Predictor of Bladder Cancer: A Monocentric Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101490. [PMID: PMID: 36295649 PMCID: PMC9607175 DOI: 10.3390/medicina58101490] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Background and objective: Fibrinogen and albumin are two proteins widely used, singularly and in combination, in cancer patients as biomarkers of nutritional status, inflammation and disease prognosis. The aim of our study was to investigate the preoperative fibrinogen-to-albumin ratio (FAR) as a preoperative predictor of malignancy as well as advanced grade in patients with bladder cancer. Materials and Methods: A retrospective analysis of patients who underwent TURBT at our institution between 2017 and 2021 was conducted. FAR was obtained from preoperative venous blood samples performed within 30 days from scheduled surgery and was analyzed in relation to histopathological reports, as was the presence of malignancy. Statistical analysis was performed using a Kruskal−Wallis Test, and univariate and multivariate logistic regression analysis, assuming p < 0.05 to be statistically significant. Results: A total of 510 patients were included in the study (81% male, 19% female), with a mean age of 71.66 ± 11.64 years. The mean FAR was significantly higher in patients with low-grade and high-grade bladder cancer, with values of 80.71 ± 23.15 and 84.93 ± 29.96, respectively, compared to patients without cancer (75.50 ± 24.81) (p = 0.006). Univariate regression analysis reported FAR to be irrelevant when considered as a continuous variable (OR = 1.013, 95% CI = 1.004−1.022; p = 0.004), while when considered as a categorical variable, utilizing a cut-off set at 76, OR was 2.062 (95% CI = 1.378−3.084; p < 0.0001). Nevertheless, the data were not confirmed in the multivariate analysis. Conclusions: Elevated preoperative FAR is a potential predictor of malignancy as well as advanced grade in patients with bladder cancer. Further data are required to suggest a promising role of the fibrinogen-to-albumin ratio as a diagnostic biomarker for bladder tumors.
Collapse
Affiliation(s)
- Biagio Barone
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Luigi Napolitano
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
- Correspondence:
| | - Pasquale Reccia
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Luigi De Luca
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Simone Morra
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Carmine Turco
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Alberto Melchionna
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Vincenzo Francesco Caputo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Luigi Cirillo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Giovanni Maria Fusco
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Francesco Mastrangelo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Francesco Paolo Calace
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Ugo Amicuzi
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Vincenzo Morgera
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Lorenzo Romano
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Massimiliano Trivellato
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Gennaro Mattiello
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Enrico Sicignano
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Francesco Passaro
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Gianpiero Ferretti
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Gaetano Giampaglia
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Federico Capone
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Felice Crocetto
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| |
Collapse
|
2
|
Lucas M, Liem EIML, Savci-Heijink CD, Freund JE, Marquering HA, van Leeuwen TG, de Bruin DM. Toward Automated In Vivo Bladder Tumor Stratification Using Confocal Laser Endomicroscopy. J Endourol 2019; 33:930-937. [PMID: 31657629 DOI: 10.1089/end.2019.0354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Purpose: Urothelial carcinoma of the bladder (UCB) is the most common urinary cancer. White-light cystoscopy (WLC) forms the corner stone for the diagnosis of UCB. However, histopathological assessment is required for adjuvant treatment selection. Probe-based confocal laser endomicroscopy (pCLE) enables visualization of the microarchitecture of bladder lesions during WLC, which allows for real-time tissue differentiation and grading of UCB. To improve the diagnostic process of UCB, computer-aided classification of pCLE videos of in vivo bladder lesions were evaluated in this study. Materials and Methods: We implemented preprocessing methods to optimize contrast and to reduce striping artifacts in each individual pCLE frame. Subsequently, a semiautomatic frame selection was performed. The selected frames were used to train a feature extractor based on pretrained ImageNet networks. A recurrent neural network, in specific long short-term memory (LSTM), was used to predict the grade of bladder lesions. Differentiation of lesions was performed at two levels, namely (i) healthy and benign vs malignant tissue and (ii) low-grade vs high-grade papillary UCB. A total of 53 patients with 72 lesions were included in this study, resulting in ∼140,000 pCLE frames. Results: The semiautomated frame selection reduced the number of frames to ∼66,500 informative frames. The accuracy for differentiation of (i) healthy and benign vs malignant urothelium was 79% and (ii) high-grade and low-grade papillary UCB was 82%. Conclusions: A feature extractor in combination with LSTM results in proper stratification of pCLE videos of in vivo bladder lesions.
Collapse
Affiliation(s)
- Marit Lucas
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Esmee I M L Liem
- Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - C Dilara Savci-Heijink
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Erik Freund
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Henk A Marquering
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ton G van Leeuwen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Daniel M de Bruin
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
3
|
Luo F, Ma C, Wu J, Li J. Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Nonmuscle-Invasive Bladder Cancer Treated with GreenLight Laser Vaporization. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:312-317. [PMID: 31084565 DOI: 10.1089/photob.2018.4592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: An elevated neutrophil-to-lymphocyte ratio (NLR) is significantly associated with poor outcomes in many types of malignancies, including bladder cancer. However, the prognostic value of NLR in patients with nonmuscle-invasive bladder cancer (NMIBC) treated with GreenLight photoselective vaporization of bladder tumor (PVBT) has not been well studied. In this study, we aimed to explore the association between NLR and survival outcomes in patients with NMIBC who underwent PVBT. Materials and methods: We retrospectively investigated 463 patients with NMIBC who underwent PVBT in Tianjin Union Medical center from January 2012 to January 2017. The patients were divided into two groups based on the NLR value (NLR ≥2.5 and NLR <2.5). Overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were determined using Kaplan-Meier analysis and the log-rank test. Results: Among 463 patients, age, tumor size, tumor focality, tumor grade, or tumor stage in the two groups did not differ significantly. The median follow-up was 40 months (range, 15-60). Thirty-eight patients (8.2%) died of any cause; 24 (5.2%) patients died of bladder cancer. In addition, 88 (19.0%) patients experienced disease recurrence. Elevated NLR was significantly associated with poor OS (χ2 = 7.457, p = 0.002), CSS (χ2 = 6.242, p = 0.012), and RFS (χ2 = 5.372, p = 0.020) in patients with NMIBC who underwent PVBT. Conclusions: Elevated preoperative NLR was significantly associated with poor OS, CSS, and RFS, and it could be considered as an effective and convenient prognostic biomarker for patients with NMIBC who were treated with PVBT.
Collapse
Affiliation(s)
- Fei Luo
- 1 Department of Urology, Tianjin Union Medical Center, Tianjin, China
| | - Chunlei Ma
- 2 Department of Urology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Jianhui Wu
- 3 Department of Urology, Tianjin First Central Hospital, Tianjin, China
| | - Jian Li
- 1 Department of Urology, Tianjin Union Medical Center, Tianjin, China
| |
Collapse
|