The Predictive Value of Preoperative ALI for the Biochemical Recurrence Rate after Laparoscopic Radical Prostatectomy

LI Linfeng; WANG Jianan; JIANG Zhaoqiang; SU Xiang; WANG Xiangyang; JI Tongyu; SHAN Lei

doi:10.14033/j.cnki.cfmr.2025.07.017

Abstract：Objective:To investigate the predictive value of preoperative advanced lung cancer inflammation index(ALI)for postoperative biochemical recurrence(BCR)in patients undergoing laparoscopic radical prostatectomy(LRP).Method:Clinical data of 232 patients receiving LRP in the Department of Urology,Henan Provincial People's Hospital from January 2021 to March 2023 were retrospectively analyzed,including age,height,weight,smoking history,body mass index(BMI),peripheral blood serological examination results and postoperative pathological findings.According to the definition of BCR issued by the European Association of Urology(EAU)in 2019,232 patients were divided into positive group and negative group according to whether BCR occurred within 1 year after surgery,and the differences between the two groups in serological indicators,ALI and pathological indicators were compared.The influencing factors were included in multi-factor regression,and receiver operating characteristic(ROC)curve was used to evaluate the prediction effect of ALI on BCR,and the optimal cut-off value was obtained.ALI was divided into high ALI group and low ALI group,and the correlation between ALI and clinicpathological characteristics was analyzed.Result:Among 232 patients with 99 cases in the BCR,overall recurrence rate was 42.67%,the single factor analysis,according to the results of preoperative 1 week,BCR group serum prostate specific antigen(PSA)>8.74 μg/L,lymphocyte-to-monocyte ratio(LMR)≤4.07,ALI≤434.98,smoking history,prognostic nutritional index(PNI)≤48.12,postoperative pathological Gleason score>7 points,tumor T stage was T3,and the proportion of positive margin was higher than that of non-BCR group,the differences was statistically significant(P<0.05).ALI before surgery was an independent protective factor for BCR(P<0.05),smoking history,PSA,high postoperative Gleason score and positive incisal margin were independent risk factors for BCR(P<0.05).The ROC curve was used to calculate the optimal critical value of ALI as 302.5(66 cases of low ALI and 166 cases of high ALI),the maximum approximate entry index was 0.402,the specificity was 88.7%,the sensitivity was 51.5%,and the area under the AUC curve was 0.750.There were significant differences in PNI,tumor T stage and Gleason score between low ALI group and high ALI group(P<0.05).Conclusion:The level of ALI before surgery is an independent protective factor for BCR after LRP,which has certain predictive value for biochemical recurrence after LRP,and can be used as a new index to predict biochemical recurrence after LRP.