Age Limit of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Correlation of Bladder Cancer Tumor Stage and Grade

Introduction: This study was conducted to investigate the predictive value of NLR and PLR with staging and grading of bladder tumors in Iran for the first time; as well as producing comprehensive data to attain defined cut-offs.Methods: The medical records of 454 patients between 2016 and 2022 have been collected and diagnosed with bladder cancer by cystoscopy and transurethral resection of bladder tumor (TURBT). Clinical and demographic parameters including age, weight, diabetes, smoking, opium usage, and hematuria were registered. The stage of BC was defined based on the results of physical exams, biopsies, and imaging tests.Results: The study comprised 393 males and 61 females ranging from 28 to 97 years old. The cut-off of NLR as a predictor of grade was 3.09 and 3.78 for the stage, which was 100.8 and 109.6 for PLR respectively. Taller people had lower PLR. There was a relationship between PLR and smoking with non-smokers having significantly higher levels of PLR (P-values=0.039 and 0.025 for grade and stage respectively). Overall NLR (AUC=71.4 and 72.4% for grade and stage respectively) and PLR (70.6 and 73.8% for grade and stage respectively) have shown predictive value for stage and grade of BC in patients younger than 65.Conclusion: Our findings suggest that PLR and NLR can be reliable predictors of the stage and grade of BC in patients under 65 years old, however, their predictor values increase when data are stratified. Higher NLR was associated with opium usage and non-O blood type.