The increasing burden of antibiotic-resistant bacteria presents a major challenge for clinical management, as conventional antimicrobial susceptibility testing (AST) depends on culture-based workflows that are slow, labor-intensive, and poorly suited for rapid clinical decision-making. Moreover, standard AST primarily reports susceptibility phenotypes, while providing little insight into the potential health risks associated with resistance dissemination and pathogenicity. Here, we develop a culture-free multimodal Raman-gene-deep learning strategy for direct phenotypic antibiotic resistance profiling and resistance risk assessment in urine samples. By integrating surface-enhanced Raman spectroscopy (SERS)-derived phenotypic fingerprints with targeted genetic information on antibiotic resistance genes and virulence factors, this approach enables resistance characterization directly from clinical samples without bacterial isolation and culture. Importantly, in addition to rapid phenotypic antibiotic resistance prediction, the proposed approach enables health risk assessment of antibiotic-resistant bacteria by integrating indicators related to clinical impact, transmission risk, and pathogenicity. Applied to clinical urine samples, the method delivers accurate phenotypic resistance results within approximately 2.5 h and simultaneously provides risk-level information that is not available from routine culture-based AST. Overall, this study presents a proof-of-concept framework for rapid phenotypic resistance prediction and risk assessment, offering enhanced informational depth, reduced operational complexity, and potential utility for antimicrobial decision-making and infection control.

This study aimed to compare the efficacy of vacuum-assisted dedusting lithotripsy (VADL), employing a flexible vacuum-assisted ureteral access sheath (FV-UAS), with traditional flexible ureteroscopic lithotripsy (fURL) for upper urinary tract stones in patients with positive urine cultures. A retrospective analysis was conducted on 421 patients treated with fURL between January 2022 and August 2024. Patients were divided into a traditional fURL group and a VADL group. Propensity score matching adjusted for baseline differences, with a 1:1 ratio applied to compare stone-free rates, operative durations, postoperative hospital stay durations, and postoperative infectious complications. Among 114 well-matched patients in each group, no mortalities occurred. The VADL group demonstrated significantly lower incidences of postoperative systemic inflammatory response syndrome (SIRS) (7.0

Microbial contamination and antibiotic-resistant bacteria (ARB) pose significant threats to environmental ecosystems, particularly in regions lacking adequate sanitation. Urinary pathogens of human origin, frequently detected in contaminated water and surfaces, represent early indicators of ARB-related exposure. However, current exposure assessment approaches rely heavily on standard strains, limiting their effectiveness in real-world scenarios. In this study, a label-free platform was developed by integrating surface-enhanced Raman spectroscopy (SERS) with a convolutional neural network (CNN) for the ARB exposure assessment. A comprehensive spectral database consisting of 368 clinical urinary isolates was established. The CNN achieved the highest classification accuracy (97.6%), surpassing random forest (93.1%) and PCA-SVM (91.2%). Robust performance was further confirmed in wastewater samples (92.2%) and independent urine specimens (90.3%). Importantly, SHAP-based interpretation revealed key discriminatory features in the 724-738 cm-1 region, associated with adenine and tryptophan, thereby enhancing model interpretability. Together, these findings establish a practical and transparent framework for microbial surveillance and ARB exposure assessment. This approach supports real-time monitoring and provides a practical tool for environmental health management.

To assess the ablation efficiency of the Superpulsed Thulium Fiber Laser (SP-TFL) and investigate the thermal effects of SP-TFL. A SP-TFLwas employed to evaluate ablation efficiency. Fresh ex-vivo pig kidneys and ureters were utilized to evaluate the renal pelvis and ureter temperature changes, different irrigation rates(0, 15, 38mL/min) and a long pulse width were used. The research indicated that as laser output power increased, ablation rates significantly increased. Ablation rates(mg/min) were higher and the energy per ablated mass(J/mg) was lower at lower frequencies(10–50 Hz). Under the same frequency and single pulse energy, super short and short pulse widths demonstrated higher ablation rates at higher frequencies (exceeding 100 Hz). The temperature of the renal pelvis and ureter decreased with increasing irrigation rates. In the renal pelvis, without irrigation, the temperature quickly reached the critical threshold of 43℃. The irrigation rate was 15 ml/min and power was no more than 18 W, the renal pelvis temperature did not reach 43℃. When the irrigation rate were 38 ml/min, the temperature did not risen to 43℃. In the ureter, without irrigation, the temperature also quickly reached 43℃. The temperature reached 43℃ when the power exceeded to12W with an irrigation rate of 15 ml/min. With an irrigation rate of 38 ml/min, the temperature reached 43℃ at a laser power of 30 W. The SP-TFL demonstrated promising ablation effectiveness especially for lower frequencies and super short and short pulse widths model. Proper irrigation rates, single pulse energy, frequency and pulse width are crucial during lithotripsy.

Abstract Background To evaluate the incidence of metabolic syndrome (MetS) in patients with unilateral and bilateral staghorn calculi (SC) and evaluate the impact on the outcome of percutaneous nephrolithotomy (PCNL). Methods The clinical data of patients who underwent PCNL for the treatment of SC between 2019 and 2022 were retrospectively reviewed. SC was divided into unilateral and bilateral. The incidence of MetS was compared between the patients with unilateral SC and the patients with bilateral SC, and the impact on the outcome of PCNL was assessed. Results A total of 1778 patients underwent PCNL between 2019 and 2022. After screening computed tomography, 379 patients were confirmed to have SC, finally, leaving 310 patients with follow-up and complete data to be included in the study. Eighty-four had bilateral SC and 226 had unilateral SC. The patients with bilateral SC had a significantly higher body mass index and higher rates of complete staghorn stones and metabolic syndrome. Higher body mass index, hypertension, diabetes mellitus, hyperlipidaemia, and MetS were present in 62.58%, 44.84%, 21.94%, 60.65% and 27.42% of all patients, respectively. The number of MetS components remained significantly associated with bilateral SC. Specifically, when the number of MetS components increases from 0 to 3–4, the likelihood of developing bilateral staghorn calculi increases by 21.967 times. Eighty-five patients with MetS( +) had a higher rate of overall complications (number (N)(%), 29 (34.12) vs.33 (14.46), P < 0.001) and a comparable stone-free rate to 225 MetS(-) patients. Multivariable analysis confirmed that hyperlipidaemia (P = 0.044, odds ratio [OR] = 1.991, 95% confidence interval [CI] 1.020–3.888) and MetS (P = 0.005, OR = 2.427, 95% CI 1.316–4.477) were independent risk factors for overall complications. Conclusions MetS is correlated with the formation of bilateral SC and is the main predictor for complications of PCNL especially for low-grade complications (I-II).

Abstract Purpose To compare the outcomes of standard-percutaneous nephrolithotomy combined ultrasonic lithotripsy system(s-PCNL+ULS) and mini-percutaneous nephrolithotomy combined high-power holmium laser(m-PCNL+hHL) for the treatment of staghorn calculus. Methods The data of patients who underwent PCNL for the treatment of staghorn calculus were retrospectively reviewed between 2019 and 2022 from the second hospital of Tianjin medical university. The nephrostomy tracts were dilatated to 24 F in standard PCNL and 16-18 F in mini PCNL, standard PCNL combined ultrasonic lithotripsy system and mini PCNL combined high-power holmium laser. The preoperative, intraoperative, and postoperative variables of the patients were calculated to evaluate the efficacy and reliability of the two groups. Results 1778 patients were received PCNL between 2019 and 2022, After screening computed tomography, finaly 310 patients with staghorn calculus were included. 98 underwent s-PCNL+ULS and 212 underwent m-PCNL+hHL. The total operative time (min) ,haemoglobin deficit (ΔHGB (g/L)) ,the postoperative hospitalization days for s-PCNL+ULS and m-PCNL+hHL groups were 76.07±26.68 vs 103.93±24.84(P＜0.001), 9.30±9.26 VS 7.73±7.50(P=0.017); 7.32±5.14 VS 4.71±2.42(P＜0.001). The incidence complications for s-PCNL+ULS and m-PCNL+hHL groups were 28.57% vs 16.04%(P = 0.064), s-PCNL+ULS group had more severity complications (9.18% vs 2.83%, P = 0.022) . The firist and second stone-free rates of PCNL were 56.12% VS 57.08%(P=0.902) and 92.86% VS 86.32%(P=0.126) for the m-PCNL+hHL and s-PCNL+ULS groups. Conclusion The efficacy of m-PCNL+hHL was comparable to s-PCNL+ULS in the treatment of staghorn calculus. The advantages of m-PCNL+hHL included the lower haemoglobin deficit, shorter hospital stay and lesser severity complications.

OBJECTIVE:To investigate the prognostic role of hematological biomarkers, especially hemoglobin-platelet ratio (HPR) in the oncological outcomes in stage 1 and grade 3 (T1G3) bladder cancer. MATERIALS AND METHODS:We identified 457 T1G3 bladder cancer patients who underwent transurethral resection of the bladder (TURB) between 2009 and 2014. Based on hematological parameters (hemoglobin-platelet ratio (HPR), hemoglobin, and platelet counts), recurrence-free survival (RFS), progression-free survival (PFS), and overall survival (OS) and cancer-specific survival (CSS) were analyzed by using Kaplan-Meier analysis. Multivariate Cox regression model was adopted to identify the predictors of oncological outcomes. RESULTS:Kaplan-Meier survival analysis showed that low HPR (< 0.615), low hemoglobin (< 125g/l) and elevated platelet counts (> 240 × 103/μl) were correlated with poor OS. Low HPR, but not low hemoglobin and high platelet counts, is associated with worse PFS. Low HPR and low hemoglobin, but not elevated platelet counts, are associated with worse CSS. However, no significant difference was observed in RFS according to any of these hematological markers. On multivariate analysis, low HPR (HR = 1.27, 95% CI = 0.81-1.75, P = 0.030), low hemoglobin (HR = 1.20, 95% CI = 0.79-1.84, P = 0.028) and elevated platelet counts (HR = 1.07, 95% CI = 0.72-1.32, P = 0.038) were significantly associated with OS. Low hemoglobin (HR = 1.08, 95% CI = 0.68-1.82, P = 0.041) was significantly linked with CSS. Particularly, low HPR was identified as an independent predictor of PFS (HR = 1.16, 95% CI = 0.97-1.49, P = 0.033) and CSS (HR = 1.14, 95% CI = 0.87-1.78, P = 0.029). CONCLUSIONS:Preoperative HPR can be taken into account as a factor predictive of oncological outcomes for T1G3 bladder cancer, particularly disease progression and mortality outcomes.

Objective To investigate the impact of squamous and/or glandular differentiation on recurrence and progression in patients with non-muscle-invasive urothelial carcinoma of bladder (NMIUCB) following transurethral resection (TURBT). Methods A total of 869 patients with NMIUCB treated with TURBT at our institution from January 2006 to January 2011 were selected retrospectively for the analysis. Correlations among squamous and/or glandular differentiation with other clinical and pathological features were assessed by chi-square. Recurrence-free survival (RFS) and progression-free survival (PFS) curves were estimated using the Kaplan-Meier method. Univariate and multivariate analyses were performed through a Cox proportional hazards regression model. Results Among 869 consecutive patients, 232 (26.7%) patients had squamous and/or glandular differentiation. High grade tumors were more common in patients with squamous and/or glandular differentiation than those with pure UCB (P<0.001). Correlations between age (P=0.115), gender (P=0.184), tumor size (P=0.223), tumor multiplicity (P=0.108), pathological tumor stage (P=0.909) and squamous and/or glandular differentiation were not statistically significant. There was a statistically prominent tendency towards higher recurrence rate and shorter RFS time in patients with squamous and/or glandular differentiation. However, no statistically significant differences were observed in progression rate and PFS between the two groups. On multivariate Cox regression analysis, squamous and/or glandular differentiation was identified as an independent prognostic predictor of recurrence (HR 1.46, 95% CI, 1.10–1.92, P=0.008). Conclusions The presence of squamous and/or glandular differentiation could be associated with higher recurrence rate and shorter RFS time in patients with NMUCB. It is an independent prognostic predictor of recurrence.

Circular RNAs (circRNAs) as a family of non-coding RNAs are increasingly recognized regarding their biogenesis, regulatory roles in gene expression and clinic significance in developmental diseases and cancers. In this study, we aim to identify circRNAs that may be associated with clinicopathological characteristics of patients with bladder cancer. The circRNAs databases CircBase and circ2 Traits were used to seek circRNAs reported to bladder cancer. The expression levels of the circRNA of interest in paired samples of tumor tissue and adjacent normal mucosa from 61 patients with bladder cancer were detected by real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and statistically analyzed. Database search shows that circASXL1 (circBase ID: hsa_circ_0001136) transcribed from the ASXL1 gene locus is among the circRNAs with altered expressions in bladder cancer. Results showed that the expression level of circASXL1 was significantly higher in bladder cancer tissues compared to that in adjacent noncancerous tissues (P<0.001). To be noticed, chi-square tests support that the expression of circASXL1 significantly correlates with tumor grade (P=0.025), tumor stage (P=0.019), lymph node invasion (P=0.011) and distant metastasis (P=0.032). The area under ROC curve (AUC) is 0.770 for circASXL1 in predicting tumor invasion (T2-T4 tumors). Kaplan-Meier survival analysis indicates that tumors of high circASXL1 expression are associated with shorter overall survival compared to tumors of low circASXL1 expression. Further, multivariate analysis reveals that circASXL1 is an independent prognostic factor for overall survival for patients with bladder cancer. Expression of circASXL1 in bladder tumor correlates with TNM classification and may independently predict overall survival for patients with bladder cancer.

Objective To evaluate the prognostic factors and the effect of adjuvant chemotherapy for T3/T4 (N0/N+) upper tract urothelial carcinoma (UTUC).Methods 92 cases of UTUC and clinical follow-up data from September 2011 to February 2016 were analyzed retrospectively.All patients underwent radical surgery and analyzed pathological examination for all surgical specimens.There was 92 cases of T3/T4(No/N+)UTUC,54 males and female;age were from 44 to 94 years,mean age was 67 years;tumor size were 1-8cm,mean size was 3.6cm.47 cases (51％)received adjuvant chemotherapy.These patients were divided into 2 groups which depend whether patents received adjuvant chemotherapy or not.Cohorts were stratified by gender,age,performance status,tumor number,size,grade and stage.The chi-square test was used to examine the relationship among the various cohorts and the receipt of adjuvant chemotherapy.Cox proportional hazard modeling and Kaplan-Meier analysis were used to determine overall and cancer specific survival in the cohort.Results The median follow-up time was 24(range:4-52)months,and during followup,21 cases(22.8％)were died for cancer,5 cases(5.4％) were died for other reasons.There was no significant difference in overall or cancer specific survival between patients who did and did not receive adjuvant chemotherapy (P ＞ 0.05).However performance state (P =0.011,P =0.034) and tumor stage (P =0.018,P =0.010) were significant predictors of overall and cancer specific survival.Conclusions This finding suggested that adjuvant chemotherapy confered minimal impact on overall survival or cancer specific survival in this group.However,performance statas and tumor stage were significant predictors of overall and cancer specific survival.

Background: Robot-assisted partial nephrectomy (RAPN) has been widely used worldwide, to determine whether RAPN is a safe and effective alternative to open partial nephrectomy (OPN) via the comparison of RANP and OPN. Methods: A comprehensive literature search was performed within the databases including PubMed, Cochrane Library, and Embase updated on 30 September 2015. Summary data with their corresponding 95 % confidence intervals (CIs) were calculated using a random effects or fixed effects model. Heterogeneity and publication bias were also evaluated. Results: A total of 16 comparative studies including 3024 cases were used for this meta-analysis. There are no significant differences in the demographic characteristic between the two groups, but the age was lower and the tumor size was smaller for the RAPN group. RAPN had a longer operative time and warm ischemia time but which showed less estimated blood loss, hospital stay, and perioperative complications. No differences existed in the margin status, the change of glomerular filtration rate, transfusion rate, and conversion rate between the two groups. There was no significant publication bias. Conclusions: RAPN offered a lower rate of perioperative complications, less estimated blood loss, and shorter length of hospital stay than OPN, suggesting that RAPN can be an effective alternative to OPN. Well-designed prospective randomized controlled trials will be helpful in validating our findings.

Bladder cancer is one of the most common malignancies worldwide and the stage pT1nonmuscle invasive bladder cancer (NMIBC) has a high probability of recurrence after initial diagnosis and treatment. However, risk factors predictive of repeated recurrence and progression of pT1 bladder tumors after primary relapse have not been uncovered. Thus, we conducted the retrospective study. A total of 418 patients who suffered initial recurrence after transurethral resection (TUR) of pT1 bladder tumor were selected for the analyses. Clinic information of the patients was retrieved from their medical records. Recurrence-free survival (RFS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method. Univariate and multivariate analyses were performed using a Cox proportional hazards regression model. The probability of recurrence and progression by multivariate analyses was used as a surrogate marker to construct receiver operating curve (ROC). Results showed that variables including time to prior recurrence time, prior treatment, number of tumor, tumor size, tumor grade, and time of instillation after surgery were associated with the repeated recurrence of pT1 bladder tumor (P < 0.05). The variables including time to prior recurrence time, tumor size, tumor grade, carcinoma in situ (CIS), and time of instillation after surgery were associated with progression of pT1 bladder tumor (P < 0.05). In the present study, the multivariate model showed an area under ROC (AUC) value of 0.754 and 0.798 for tumor recurrence and progression, respectively, which was more effective in prediction than a single risk factor. In conclusion, we have identified several risk factors relevant to RFS and PFS for patients who have had a history of recurrence of pT1 bladder tumor after TUR. These predictive factors may help urologists to stratify patients into distinct risk groups of recurrence and progression, which probably contributes to the individualized treatment for patients.

OBJECTIVE:The objective of this article was to summarize the relationship between some components of metabolic syndrome (MetS) and the histopathologic findings in bladder cancer in a Chinese population.METHODS:We retrospectively analyzed data of 323 patients from the Department of Urology, Second Hospital of Tianjin Medical University between January 2012 and January 2014. All the patients were diagnosed with bladder cancer for the first time. Age, height, weight, histologic stage, grade, the presence of hypertension, diabetes mellitus, and body mass index were evaluated. The 2009 American Joint Committee on Cancer TNM staging system was used, with Ta and T1 tumors accepted as lower stage and T2, T3, and T4 tumors as higher stage bladder cancers. Also, pathologists assigned tumor grade according to the 1973 World Health Organization grading system. Noninvasive papillary urothelial neoplasms of low malignant potential were regarded as low grade. Analyses were completed using chi-square tests and logistic regression analysis.RESULTS:Of the 323 patients, 164 had hypertension, 151 had diabetes mellitus, and 213 had a body mass index ≥25 kg/m(2). MetS was significantly associated with histologic grade (P<0.001) and stage (P=0.006) of bladder cancer. Adjusted for age in binary logistic regression analysis, the presence of MetS predicts the risk of higher T stage (odds ratio =4.029, P<0.001) and grade (odds ratio =3.870, P<0.001) of bladder cancer.CONCLUSION:The patients with MetS in the People's Republic of China were found to have statistically significant higher T stage and grade of bladder cancer.

Objective: The aim of this study is to identify the risk factors in relation to survival of patients with small cell carcinoma of the upper urinary tract (UUT-SCC).

Background Long noncoding RNAs (lncRNAs) have been implicated playing important roles in human urologic cancers. Up to date, quite a few lncRNAs have been implicated as promising biomarkers for tumor early detection and prognosis monitoring. Methods In the present study, microarray analysis was initially performed to screen the differentially expressed lncRNAs between bladder cancer tissues and paired adjacent non-cancerous tissues (n=3).Subsequent qRT-PCR validation was conducted using tissue samples from 95 patients with bladder cancer. Results Results showed that the expression level of lncRNA-n336928 (noncode database ID: n336928) was significantly higher in bladder cancer tissues compared to that in adjacent noncancerous tissues (P<0.001). Chi-square test showed that expression of lncRNA-n336928 was positively correlated with bladder tumor stage and histological grade (P<0.001). Kaplan-Meier survival analysis revealed that patients with bladder cancer with high expression of lncRNA-n336928 had shorter overall survival time compared to patients with low expression of lncRNA-n336928. Multivariate analysis indicated that lncRNA-n336928 was an independent prognostic factor for overall survival for bladder cancer patients. Conclusions our study shows that high expression of lncRNA-n336928 is associated with the progression of bladder cancer, and that lncRNA-n336928 might serve as a biomarker for prognosis of bladder cancer

Objective To explore the clinical, pathology, and prognosis of sarcomatoid carcinoma of the renal pelvis.

Objective: The management of stage 1 and grade 3 (T1G3) bladder cancer continues to be controversial. Although the transurethral resection of bladder tumor (TURBT) followed by intravesical chemotherapy is a conservative strategy for treatment of T1G3 bladder cancer, a relatively high risk of tumor recurrence and progression remains regarding the therapy. This study aimed to compare the efficacy of intravenous chemotherapy combined with intravesical chemotherapy versus intravesical chemotherapy alone for T1G3 bladder cancer after TURBT surgery. Methods: We retrospectively reviewed the cases of 457 patients who were newly diagnosed with T1G3 bladder urothelial carcinoma between January 2009 and March 2014. After TURBT, 281 patients received intravesical chemotherapy alone, whereas 176 patients underwent intravesical chemotherapy in combination with intravenous chemotherapy. Tumor recurrence and progression were monitored periodically by urine cytology and cystoscopy in follow-up. Recurrence-free survival and progression-free survival of the two chemotherapy strategies following TURBT were analyzed. Univariable and multivariable Cox hazards analyses were performed to predict the prognostic factors for tumor recurrence and progression. Results: The tumor recurrence rate was 36.7% for patients who received intravesical chemotherapy alone after TURBT, compared with 19.9% for patients who received intravenous chemotherapy combined with intravesical chemotherapy after TURBT (P<0.001). The progression rate was 10.6% for patients who underwent intravesical chemotherapy alone and 2.3% for patients who underwent the combined chemotherapies (P=0.003). Kaplan-Meier curves showed significant differences in recurrence-free survival and progression-free survival between the two treatment strategies, with a log-rank P-value of <0.001 and 0.003, respectively. Multivariable analyses revealed that intravenous chemotherapy was the independent prognostic factor for tumor recurrence and progression in the cohort. Conclusion: Intravenous chemotherapy combined with intravesical chemotherapy offers a better oncologic outcome than the intravesical chemotherapy alone for patients with T1G3 bladder urothelial carcinoma after TURBT, and it may be considered as a new therapy strategy for T1G3 bladder cancer.

This study aimed to determine the expression status of actin-binding protein Girdin in non-muscle invasive bladder cancer (NMIBC) tissues, and to explore the relationships between Girdin expression and the clinicopathological characteristics of bladder carcinoma. The correlations between Girdin expression and the clinicopathological parameters were examined by Chi-square test. Recurrence-free survival (RFS) and progression-free survival (PFS) were analyzed using Kaplan-Meier method. The prognostic significance of Girdin expression was assessed using univariate and multivariate Cox regression analysis models. Results showed that 69 (43.1%) of the 160 NMIBC tissue samples displayed positive expression of Girdin; Girdin positivity was more frequently seen in high-grade tumors than in low-grade tumors (P = 0.019), and in undifferentiated tumors than in differentiated tumors (P = 0.028). In Kaplan-Meier analysis, expression of Girdin was significantly associated with lower RFS (P = 0.007) and PFS (P = 0.024) rates. The univariate analysis revealed that Girdin expression was a risk factor for both recurrence and progression of NMIBC. Further multivariate analysis identified Girdin as an independent predictor of tumor recurrence (hazard ratio [HR]: 2.056, 95% CI: 1.213-3.483, P = 0.007). The present study suggests that Girdin is differentially expressed in bladder tumors and may represent an independent predictor of prognosis for patients with NMIBC.

Objective To assess the value of preoperative neutrophil-lymphocyte ratio ( NLR) for predict the prognosis in patients with high grade T1 bladder.Methods From January 2004 to December 2014, the data of 307 patients diagnosed as bladder cancer of Stage 1 and high grade after undergoing TURBT were analyzed, including gender, age, smoking status, tumor number and size, hydronephrosis, intravesical instillations and preoperative blood transfusion of 307 patients diagnosed as bladder cancer of stage 1 and high grade after undergoing TURBT were analyzed retrospectively.All patients were primary urothelial carcinoma.According to preoperative NLR,patients were divided into the low NLR group( NLR≤2.42,n=197) and the high NLR group(NLR >2.42,n =110).Recurrence-free survival (RFS) and progression-free survival ( PFS) were calculated according to the Kaplan-Meier model and compared by the log-rank model.Cox regression models were used for multivariate analyses of the association between NLR and bladder cancer, then the prognostic factors affecting RFS and PFS were evaluated.Result of these 307 patients, the low NLR group accounted for 64.2%(197/307), and the high NLR group accounted for 35. 8%(110/307).The mean follow-up period was 71(range, 1-123)months.The recurrence rate in the low NLR group and the high NLR group recurrence rate were 19.2%( 38/197 ) and 34.5%( 38/110 ) respectively, RFS were 73.0(range, 2-123)months and 67.5(range, 1-122)months respectively.The progression rates were 4.1%(8/197) and 10.9%(12/110) respectively.The recurrence and progression rates in the high NLR group is higher than those in the low NLR group(P<0.01 and P=0.008), and RFS was shorter( P=0.002).Multivariable Cox regression analysis showed that NLR>2.42(P=0.007,HR=1.912)and hydronephrosis (P<0.01, HR =2.485 ) are associated with higher risk of recurrence.Conclusion Elevated preoperative NLR is an independent predictor of RFS and PFS in patients with high grade T1 bladder cancer.

目的:探讨非肌层浸润性膀胱癌(non-muscle-invasive bladder cancer,NMIBC)伴术前脓尿患者的临床特点及脓尿对其预后方面的临床意义.方法:回顾性分析2009年11月～2011年3月我院278例首发非肌层浸润性膀胱癌患者的临床病理资料.定义脓尿为每高倍视野下尿白细胞数量≥5个,根据术前尿白细胞值,将患者分为脓尿-组(尿白细胞＜5)和脓尿+组(尿白细胞≥5),运用卡方检验分析脓尿和各临床病理特点之间的关系,运用Kaplan-Meier法比较两组之间无复发生存期(recurrence-free survival,RFS)和无进展生存期(progression-free survival,PFS)的区别,并用Log-rank检验评估其统计学意义.结果:278例NMIBC患者中,有98例(35.3％)出现术前脓尿,平均随访48.6(3～72)个月.在随访期间内,脓尿的出现与大体积、多发、高TNM分期、高级别肿瘤以及高复发率和高进展率显著相关,且经Kaplan-Meier法分析发现,脓尿+组患者无复发生存率明显低于脓尿-组患者(58.2％ vs.71.7％,P=0.016);同样,脓尿+组患者无进展生存率也明显低于脓尿-组患者(74.5％ vs.85.6％,P=0.018).结论:非肌层浸润性膀胱癌伴术前脓尿患者肿瘤多发且体积大,组织学分级和临床分期高,预后较差,应积极手术治疗并术后密切随访.