Preoperative High Neutrophil-to-Lymphocyte Ratio Is Associated with High-grade Bladder Cancer.

Aim: To evaluate the correlation between the neutrophil-to-lymphocyte ratio (NLR) and histopathological characteristics of bladder cancer. Materials and Methods: A retrospective analysis was performed on a cohort of patients (n=302) who were diagnosed with bladder cancer and underwent transurethral resection of bladder tumor or cystectomy between 2009 and 2016. The pathological outcomes were compared between patients with low NLR and those with high NLR with a cut-off value of 2.5, and a logistic regression analysis was performed to find potential predictors of pathological tumor outcomes. Results: Patients with high-grade disease had significantly higher NLRs compared to those with low-grade disease (median NLR=4.42 vs. 3.42, p<0.001). Univariate analysis suggested that age, neutrophil count and NLR, as a continuous or binary variable, were significantly associated with high-grade disease. Multivariate analysis suggested that age and NLR, as a continuous variable, were predictors of pathologically high-grade disease. Conclusion: Preoperative NLR was found to be associated with pathological tumor grading, but was not associated with pathological tumor staging in patients with bladder cancer.