Prognostic Value of Monocyte to High-Density Lipoprotein Cholesterol Ratio in Non-Muscle Invasive Bladder Cancer: Retrospective-Cohort Analyses

Objective: The objective of this study was to examine the prognostic value of Monocyte to High-Density Lipoprotein cholesterol ratio (MHR) in patients with non-muscle-invasive bladder cancer (NMIBC) who underwent transurethral resection of the bladder tumour (TUR-B). Material and Methods: This retrospective analysis was conducted on data from patients who had undergone a TUR-B procedure for bladder cancer and whose pathology result was NMIBC pure urethelial cell carcinoma. Progression was defined as an increase in stage, indicating the advancement of the disease to the lamina propria or to muscle-invasive disease. The patients were divided into 2 groups according to their progression status. The mean MHR values and other clinicopathological features of the 2 groups were then compared. Results: The significant difference between the 2 groups was also found in the MHR. The median MHR was 1.8 in the progression group and 1.57 in the non-progression group. The receiver operating characteristic analysis yielded an optimal cut-off point for MHR of 1.72. At this value, the sensitivity was 81.6% and the specificity was 81.9%. While all parameters demonstrated a statistically significant impact on progression in both univariate and multivariate analyses, high MHR was identified as having a stronger effect than other parameters. The mean progression time was 55.5 months in patients with a low MHR value (<1.72) and 29.1 months in the high MHR group (>1.72). Conclusion: MHR can be incorporated into existing scoring systems as a costeffective and readily quantifiable marker that can forecast advancement cancer in NMIBC patients.