Inflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer

Introduction: Patients with bladder cancer have a high risk of venous thrombosis that represents a key challenge for physicians in the decision-making for initiating anticoagulation therapy. Non-muscle-invasive bladder cancer (NMIBC) represents more than 70% of all diagnosed bladder malignancies; th...

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Autores principales:	Daniel Balan, Mihai Dorin Vartolomei, Annamária Magdás, Noemi Balan-Bernstein, Septimiu Toader Voidăzan, Orsolya Mártha
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	IMPROVE neutrophil to lymphocyte ratio complete blood count lymphocyte to monocyte ratio Medicine R
Acceso en línea:	https://doaj.org/article/3ff50092261c40ca8afe45d38ff83838
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spelling	oai:doaj.org-article:3ff50092261c40ca8afe45d38ff838382021-11-25T18:01:08ZInflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer10.3390/jcm102252702077-0383https://doaj.org/article/3ff50092261c40ca8afe45d38ff838382021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5270https://doaj.org/toc/2077-0383Introduction: Patients with bladder cancer have a high risk of venous thrombosis that represents a key challenge for physicians in the decision-making for initiating anticoagulation therapy. Non-muscle-invasive bladder cancer (NMIBC) represents more than 70% of all diagnosed bladder malignancies; therefore, we aimed to evaluate the relationship of the neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and risk of thrombosis by using the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) score as well as the risk of bleeding by using the IMPROVE Bleeding Risk Assessment Score in a study cohort. Material and Methods: This was a retrospective observational study involving 130 patients who met the inclusion criteria: age > 18 years, stage pTa-pT1 NMIBC. The exclusion criteria were age < 18 years; stage pT2 or higher; or a presentation of metastasis, inflammatory, liver or autoimmune diseases, or other systemic neoplasms. In order to evaluate the risk of thromboembolic events as well as those of bleeding, the IMPROVE scores were calculated for each patient. Subjects were categorized in a Low IMPROVE group (< 4 points) or a High IMPROVE group. By using uni- and multivariate regression models, we analyzed CBC-derived parameters which could be associated with a higher risk of venous thrombosis in subjects with low or high IMPROVE scores. Results: Patients with IMPROVE score greater than 4 were associated with higher NLR, LMR and lymphocyte values (<i>p</i> < 0.05). In a multivariate regression model, the IMPROVE score was significantly influenced by lymphocyte count (<i>p</i> = 0.007) as well as the NLR value (<i>p</i> < 0.0001). Conclusions: In our study population, subjects with NMIBC with low lymphocytes and NLR > 3 were at a higher risk of developing venous thromboembolic events, reflected by an IMPROVE score of greater than 4. The IMPROVE and IMPROVE Bleeding Risk Assessment Scores are easy to use, and, complemented with the CBC-derived lymphocyte to monocyte ratio as a prothrombotic marker, could aid in the decision of prophylactic anticoagulation therapy during admission.Daniel BalanMihai Dorin VartolomeiAnnamária MagdásNoemi Balan-BernsteinSeptimiu Toader VoidăzanOrsolya MárthaMDPI AGarticleIMPROVEneutrophil to lymphocyte ratiocomplete blood countlymphocyte to monocyte ratioMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5270, p 5270 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	IMPROVE neutrophil to lymphocyte ratio complete blood count lymphocyte to monocyte ratio Medicine R
spellingShingle	IMPROVE neutrophil to lymphocyte ratio complete blood count lymphocyte to monocyte ratio Medicine R Daniel Balan Mihai Dorin Vartolomei Annamária Magdás Noemi Balan-Bernstein Septimiu Toader Voidăzan Orsolya Mártha Inflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer
description	Introduction: Patients with bladder cancer have a high risk of venous thrombosis that represents a key challenge for physicians in the decision-making for initiating anticoagulation therapy. Non-muscle-invasive bladder cancer (NMIBC) represents more than 70% of all diagnosed bladder malignancies; therefore, we aimed to evaluate the relationship of the neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and risk of thrombosis by using the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) score as well as the risk of bleeding by using the IMPROVE Bleeding Risk Assessment Score in a study cohort. Material and Methods: This was a retrospective observational study involving 130 patients who met the inclusion criteria: age > 18 years, stage pTa-pT1 NMIBC. The exclusion criteria were age < 18 years; stage pT2 or higher; or a presentation of metastasis, inflammatory, liver or autoimmune diseases, or other systemic neoplasms. In order to evaluate the risk of thromboembolic events as well as those of bleeding, the IMPROVE scores were calculated for each patient. Subjects were categorized in a Low IMPROVE group (< 4 points) or a High IMPROVE group. By using uni- and multivariate regression models, we analyzed CBC-derived parameters which could be associated with a higher risk of venous thrombosis in subjects with low or high IMPROVE scores. Results: Patients with IMPROVE score greater than 4 were associated with higher NLR, LMR and lymphocyte values (<i>p</i> < 0.05). In a multivariate regression model, the IMPROVE score was significantly influenced by lymphocyte count (<i>p</i> = 0.007) as well as the NLR value (<i>p</i> < 0.0001). Conclusions: In our study population, subjects with NMIBC with low lymphocytes and NLR > 3 were at a higher risk of developing venous thromboembolic events, reflected by an IMPROVE score of greater than 4. The IMPROVE and IMPROVE Bleeding Risk Assessment Scores are easy to use, and, complemented with the CBC-derived lymphocyte to monocyte ratio as a prothrombotic marker, could aid in the decision of prophylactic anticoagulation therapy during admission.
format	article
author	Daniel Balan Mihai Dorin Vartolomei Annamária Magdás Noemi Balan-Bernstein Septimiu Toader Voidăzan Orsolya Mártha
author_facet	Daniel Balan Mihai Dorin Vartolomei Annamária Magdás Noemi Balan-Bernstein Septimiu Toader Voidăzan Orsolya Mártha
author_sort	Daniel Balan
title	Inflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer
title_short	Inflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer
title_full	Inflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer
title_fullStr	Inflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer
title_full_unstemmed	Inflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer
title_sort	inflammatory markers and thromboembolic risk in patients with non-muscle-invasive bladder cancer
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3ff50092261c40ca8afe45d38ff83838
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Inflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer

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