术前低血浆肌酸激酶水平预示根治性膀胱切除术后膀胱癌患者的生存结局更差。
Preoperative low plasma creatine kinase levels predict worse survival outcomes in bladder cancer after radical cystectomy.
机构信息
Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
出版信息
Int Urol Nephrol. 2024 Jul;56(7):2215-2225. doi: 10.1007/s11255-024-03957-2. Epub 2024 Feb 5.
BACKGROUND AND AIMS
To evaluate the prognostic significance of preoperative creatine kinase (CK) levels in bladder cancer (BCa) patients who underwent radical cystectomy (RC).
MATERIALS AND METHODS
570 BCa patients with RC were identified between 2010 and 2020. 108.5 U/L of CK levels were defined as the cutoff value. Logistic regression analysis and Cox regression models were performed to evaluate the association between CK levels and oncologic outcomes. Subgroup analyses were performed to address cofounding factors.
RESULTS
Preoperative low CK levels were associated with worse recurrence-free survival (RFS, log-rank P = 0.001) and overall survival (OS, log-rank P = 0.002). Multivariate analysis revealed that preoperative low CK levels were an independent predictor for worse RFS (hazard ratio [HR]: 1.683; P < 0.001) and OS (HR: 1.567; P = 0.002).
CONCLUSIONS
The preoperative low CK level independently predicts worse survival outcomes in BCa after RC. Incorporating it into prediction models might be valuable to assist risk stratification.
背景与目的
评估接受根治性膀胱切除术（RC）的膀胱癌（BCa）患者术前肌酸激酶（CK）水平的预后意义。
材料与方法
2010 年至 2020 年间，共确定了 570 例接受 RC 的 BCa 患者。将 CK 水平 108.5 U/L 定义为截断值。采用 logistic 回归分析和 Cox 回归模型评估 CK 水平与肿瘤学结局之间的关联。进行亚组分析以解决混杂因素。
结果
术前低 CK 水平与更差的无复发生存率（RFS，对数秩 P=0.001）和总生存率（OS，对数秩 P=0.002）相关。多变量分析显示，术前低 CK 水平是 RFS（危险比 [HR]：1.683；P<0.001）和 OS（HR：1.567；P=0.002）更差的独立预测因素。
结论
术前低 CK 水平独立预测 RC 后 BCa 的生存结局更差。将其纳入预测模型可能有助于风险分层。
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