SIGNIFICANCE OF TUMOR-ASSOCIATED NEUTROPHILS, LYMPHOCYTES, AND NEUTROPHIL-TO-LYMPHOCYTE RATIO IN NON-INVASIVE AND INVASIVE BLADDER UROTHELIAL CARCINOMA

Background: Bladder cancer accounts for 3% of global cancer diagnoses and is estimated to be the 7th most common cancer worldwide. Urothelial carcinoma is the most common type of bladder cancer, constituting up to 95% of bladder malignancies. Tumor-infiltrating neutrophils and lymphocytes play essential roles in promoting or combating various neoplasms. Aim of the study: This study aimed to investigate the association between tumor- Infiltrating neutrophils and lymphocytes and the neutrophil-to-lymphocyte ratio in the progression of urothelial carcinoma. Material and Method: This study included 100 patients pathologically diagnosed with urothelial bladder neoplasm by TURBT from November 2023 to November 2024. Clinical and pathological data of age, sex, pathological grade, and pTNM stage were recorded. The tumors were classified and graded according to the 2022 World Health Organization/ International Society of Urological Pathology classification. Results: Regarding the presented study, the percentage of total cases (100%) was diagnosed with urothelial cancer. The presence of neutrophils and the neutrophil-to-lymphocyte ratio correlated with high-grade urothelial neoplasms. In both low- and high-grade tumors, the lymphocytes increased during progression from a non-invasive neoplasm to an early-invasive neoplasm. Lymphocytes increased in low-grade non–muscle-invasive tumors compared to invasive tumors. There was a significant decrease in lymphocytes during progression to muscle-invasive tumors. Conclusion: Our results suggest that tumor-infiltrating neutrophils, lymphocytes and N: L ratio has a significant effect on tumor grade and invasion.