Predictive Value of Preoperative Prognostic Nutritional Index Combined with Serum KLF5 and PON1 for Recurrence in Bladder Cancer Patients After Transurethral Resection
Liu Cuixia
Ding Jing
Hu Lixia
Abstract：Objective To investigate the predictive value of preoperative prognostic nutritional index(PNI)com-bined with serum Krüppel-like factor 5(KLF5)and paraoxonase 1(PON1)for postoperative recurrence in bladder cancer pa-tients undergoing transurethral resection.Methods A total of 135 bladder cancer patients diagnosed and treated with trans-urethral resection in Mianyang Central Hospital from January 2020 to January 2022 were prospectively enrolled as subjects.They were divided into the recurrence group(n=42)and non-recurrence group(n=93)based on postoperative recurrence sta-tus.The PNI was calculated from preoperative blood routine test results.Serum KLF5 and PON1 levels were measured using enzyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was performed to evaluate the correlations be-tween preoperative PNI and serum KLF5 and PON1 levels in bladder cancer patients.Logistic regression analysis was used to identify the key factors influencing postoperative recurrence in bladder cancer patients.Receiver operating characteristic(ROC)curve was applied to assess the predictive value of preoperative PNI combined with serum KLF5 and PON1 for post-operative recurrence in bladder cancer patients.Results During the 2-year postoperative follow-up,42 out of 135 bladder cancer patients experienced recurrence,with a recurrence rate of 31.11%.The proportions of multiple tumors and T1 stage tu-mors,as well as serum KLF5 levels in the recurrence group were significantly higher than those in the non-recurrence group(P<0.05),while preoperative PNI and serum PON1 levels were significantly lower in the recurrence group(P<0.05).Pre-operative PNI was negatively correlated with serum KLF5 levels(r=-0.709,P<0.001)and positively correlated with serum PON1 levels(r=0.675,P<0.001).Elevated serum KLF5 levels were identified as risk factors for postoperative recurrence in bladder cancer patients,whereas increased preoperative PNI and serum PON1 levels were protective factors(P<0.05).The areas under the curve(AUCs)of preoperative PNI,serum KLF5,serum PON1 alone and their combination for predicting postoperative recurrence in bladder cancer patients were 0.820,0.868,0.826 and 0.955,respectively;the sensitivities were 66.67%,80.95%,73.81%and 90.48%,respectively;and the specificities were 87.10%,91.40%,78.49%and 88.17%,respec-tively.The predictive efficacy of the combined detection was superior to that of single detection(Z combination-PNI=3.814,Z combina-tion-KLF5=2.819,Z combination-PON1=3.792,P<0.05).Conclusion Elevated serum KLF5 levels,decreased preoperative PNI and serum PON1 levels in bladder cancer patients are closely associated with postoperative recurrence after transurethral resection.The combined detection of the three indicators has higher value in predicting postoperative recurrence in such patients.
Keywords：prognostic nutritional indexkrüppel-like factor 5paraoxonase 1bladder cancerrecurrence
Publication Date：2025-12-28
Online Publishing Date：2026-03-11(First online date of this platform, not the publication date of the document)
Pages：5( 391-395 )