术前炎症指标对未触及腹股沟淋巴结的pT1a期阴茎鳞癌患者淋巴结转移的预测价值OA北大核心CSTPCD

Objective:To investigate the predictive value of three preoperative inflammatory markers for lymph node metastasis in patients with pT1a stage penile squamous carcinoma without palpable inguinal lymph nodes.Methods:Clinical data of 103 patients with pT1a stage penile squamous carcinoma admitted to the First Affiliated Hospital of Soochow University and Taixing People's Hospital from January 2012 to June 2023 were collected.Patients were divided into lymph node metastasis group and non-lymph node metastasis group based on postoperative pathological findings of inguinal lymph node involvement.Differences in age,body mass index(BMI),hypertension,diabetes mellitus,tumor diameter,neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),lymphocyte-to-monocyte ratio(LMR),and postoperative pathological grading were compared between the two groups.Independent risk factors for lymph node metastasis were screened using univariate and multivariate logistic regression analyses.Receiver operating characteristic(ROC)curves were performed to compare the predictive value of inflammatory markers for lymph node metastasis in patients with pT1a stage penile squamous carcinoma,and the predictive efficacy of each inflammatory markersfor lymph node metastasis was evaluated after adjusting sensitivity to 100％.Results:There were 24 cases(23.3％)in the inguinal lymph node metastasis group and 79 cases(76.7％)in the non-lymph node metastasis group.The differences between the two groups were statistically significant in terms of NLR(P＜0.001),PLR(P=0.035),and LMR(P＜0.001).Multivariateanalysis showed that NLR(P=0.045)and LMR(P=0.021)were independent risk factors for inguinal lymph node metastasis in pT1a stage penile cancer.ROC curve analysis results showed that the area under the curve for NLR,LMR,and NLR+LMR were 0.833,0.816,and 0.835 respectively.The optimal cut-off value for NLR was 2.33,with a sensitivity of 95.8％and a specificity of 68.4％;the optimal cut-off value for LMRwas 3.80,with a sensitivity of 79.2％and a specificity of 78.5％;the sensitivity and specificity of combined detection of NLR+LMR were 83.3％and 74.7％,respectively.When adjusting sensitivity to 100％,the specificity of NLR and LMR for predicting inguinal lymph node metastasis in pT1a stage peniles quamous carcinoma was 50.6％and 2.5％,with cut-off values of 1.79 and 11.01.Conclusion:NLR and LMR are independent predictive factors for inguinal lymph node metastasis in pT1a stage penile squamous carcinoma.NLR＞2.33 and LMR＜3.80 suggest that patients are at great risk of lymph node metastasis,and lymph node dissection surgery is recommended to improve patient survival.