Value of albumin-to-alkaline phosphatase ratio with modified Glasgow prognostic score in assessing response and prognosis of non-muscle invasive bladder cancer patients undergoing intravesical BCG therapy
10.3969/j.issn.1009-8291.2025.10.012
- VernacularTitle:白蛋白与碱性磷酸酶比值联合改良Glasgow预后评分对非肌层浸润性膀胱癌患者膀胱内灌注卡介苗治疗响应和预后的评估价值
- Author:
Kunpeng XIE
1
;
Tianyu ZHANG
1
;
Donglai LIU
1
;
Yongjie MIAO
1
;
Renfu CHEN
1
Author Information
1. 徐州医科大学附属医院泌尿外科,江苏徐州 221000
- Publication Type:Journal Article
- Keywords:
non-muscle invasive bladder cancer;
albumin-to-alkaline phosphatase ratio;
modified Glasgow prognostic score;
intravesical Bacillus Calmette-Guérin therapy;
therapeutic response;
prognosis
- From:
Journal of Modern Urology
2025;30(10):881-888
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of the albumin-to-alkaline phosphatase ratio(AAPR)with modified Glasgow prognostic score(mGPS)in assessing the response to and prognosis of intravesical Bacillus Calmette-Guérin(BCG)therapy in patients with non-muscle invasive bladder cancer(NMIBC).Methods A total of 153 high-risk NMIBC patients treated with intravesical BCG in our hospital during Jan.2018 and Oct.2021 were enrolled.Patients were divided into response and non-response groups based on the treatment efficacy,and into good and poor prognosis groups based on the clinical outcomes.AAPR and mGPS were calculated.The relationship between AAPR,mGPS and BCG treatment non-response was analyzed with multivariate logistic regression.Clinical data and scores were compared between prognosis groups.The associations between AAPR,mGPS,and poor prognosis after BCG treatment were assessed with a Cox proportional hazards model.Patients were stratified into high-and low-A APR groups,and into mGPS 0,1,and 2 groups.Kaplan-Meier survival curves were plotted for progression-free survival(PFS)across different AAPR and mGPS strata.The diagnostic performance of AAPR combined with mGPS in predicting treatment non-response and poor prognosis was evaluated using receiver operating characteristic(ROC)curves.Results Among the 153 patients,the response rate to BCG treatment was 71.90％(110/153),the 3-year poor prognosis rate was 45.75％(70/153),and the 3-year PFS rate was 54.25％(83/153).Increased AAPR was identified as an independent protective factor for both treatment response and good prognosis,while higher mGPS was an independent risk factor(P＜0.05).The 3-year PFS rate was significantly higher in the high-AAPR group than in the low-A APR group(P＜0.001).Among the mGPS groups,the 3-year PFS rate was lowest in the mGPS 2 group,followed by mGPS 1 and mGPS 0 groups(P＜0.001).The area under the ROC curve(AUC)for AAPR with mGPS in predicting BCG treatment non-response and poor prognosis was 0.864 and 0.901,respectively,significantly higher than using AAPR(0.774,0.781)or mGPS alone(0.798,0.809)(P＜0.05).Conclusion Lower AAPR and higher mGPS are associated with non-response and poor prognosis in NMIBC patients undergoing intravesical BCG therapy.The combination of AAPR and mGPS has high predictive value.
