Analysis of the correlation between prothrombin time and postoperative recurrence in bladder cancer patients who underwent endoscopic cryoablation therapy

doi:10.3877/cma.j.issn.1674-3253.2026.02.004

Abstract

Abstract:

Objective

Cryoablation, as a minimally invasive treatment, is widely used in bladder cancer. However, postoperative recurrence remains relatively high, and reliable biomarkers for predicting recurrence risk are still lacking. This study aims to explore the correlation between laboratory indicators and recurrence risk after cryoablation of bladder cancer.

Methods

This study is a post-hoc analysis based on a cohort of bladder cancer patients from a multicenter, prospective, randomized controlled trial (ChiCTR registration number: ChiCTR-INR-17013060). All patients underwent laboratory testing on postoperative day 7 and at 4-6 weeks. Recurrence was assessed over a 3-year follow-up period using ultrasound and cystoscopy. Univariate and multivariate Logistic regression analyses were conducted between the recurrence and non-recurrence groups. Patients were grouped according to prothrombin time (PT) using the optimal cutoff value, and the relationship between different groups and clinicopathological characteristics was evaluated.

Results

A total of 72 patients were included, with 11 experiencing recurrence during follow-up. Univariate Logistic regression analysis showed that age (OR=1.082, 95%CI: 1.008-1.173, P=0.039), tumor number (OR=2.851, 95%CI: 1.295-6.773, P=0.011), and PT on postoperative day 7 (OR=0.423, 95%CI: 0.164-0.889, P=0.043) were significantly associated with recurrence. Multivariate analysis identified shortened PT on postoperative day 7 as an independent risk factor of recurrence (OR=0.222, 95%CI: 0.053-0.602, P=0.013). When patients were stratified by a PT cutoff value of 12.1 seconds, patients in the low PT group had a higher proportion of low-grade tumors (P=0.028), higher platelet levels (P=0.014), and shorter activated partial thromboplastin time (P<0.001).

Conclusion

Shortened PT on postoperative day 7 is an independent risk factor of recurrence after bladder cancer cryoablation.

Key words: Cryoablation, Bladder cancer, Recurrence, Coagulation

Zaixun Song, Jinzhong Hu, Qiuping Yin, Yiling Chen, Tian'an Dang, Zezhong Mou, Chenyang Xu, Haowen Jiang. Analysis of the correlation between prothrombin time and postoperative recurrence in bladder cancer patients who underwent endoscopic cryoablation therapy[J]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(02): 147-153.

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References 31

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变量	单因素Logistic回归分析			多因素Logistic回归分析
变量	OR	95%CI	P值	OR	95%CI	P值
年龄	1.082	1.008~1.173	0.039	1.045	0.999~1.232	0.051
性别	0.510	0.026~3.144	0.542
BMI	0.796	0.574~1.052	0.128
肿瘤数量	2.851	1.295~6.773	0.011	2.820	1.085~8.140	0.039
肿瘤最大径	1.611	0.679~3.967	0.281
红细胞	0.549	0.144~2.093	0.369
血红蛋白	0.979	0.929~1.028	0.401
白细胞	1.067	0.879~1.289	0.497
血小板	1.002	0.992~1.012	0.624
凝血酶原时间	0.423	0.164~0.889	0.043	0.222	0.053~0.602	0.013
凝血酶时间	1.023	0.521~1.950	0.944
活化部分凝血活酶时间	0.891	0.750~1.022	0.140
纤维蛋白原	1.001	0.996~1.005	0.760
谷丙转氨酶	0.960	0.885~1.013	0.249
谷草转氨酶	0.958	0.833~1.059	0.475
总胆红素	0.986	0.900~1.046	0.710
肌酐	0.981	0.936~1.017	0.353

变量	单因素Logistic回归分析			多因素Logistic回归分析
变量	OR	95%CI	P值	OR	95%CI	P值
年龄	1.082	1.008~1.173	0.039	1.045	0.999~1.232	0.051
性别	0.510	0.026~3.144	0.542
BMI	0.796	0.574~1.052	0.128
肿瘤数量	2.851	1.295~6.773	0.011	2.820	1.085~8.140	0.039
肿瘤最大径	1.611	0.679~3.967	0.281
红细胞	0.549	0.144~2.093	0.369
血红蛋白	0.979	0.929~1.028	0.401
白细胞	1.067	0.879~1.289	0.497
血小板	1.002	0.992~1.012	0.624
凝血酶原时间	0.423	0.164~0.889	0.043	0.222	0.053~0.602	0.013
凝血酶时间	1.023	0.521~1.950	0.944
活化部分凝血活酶时间	0.891	0.750~1.022	0.140
纤维蛋白原	1.001	0.996~1.005	0.760
谷丙转氨酶	0.960	0.885~1.013	0.249
谷草转氨酶	0.958	0.833~1.059	0.475
总胆红素	0.986	0.900~1.046	0.710
肌酐	0.981	0.936~1.017	0.353

变量	单因素Logistic回归分析
变量	OR	95%CI	P值
年龄	1.070	1.002~1.142	0.043
性别	2.120	0.271~16.576	0.474
BMI	0.806	0.616~1.054	0.115
肿瘤数量	2.705	1.334~5.485	0.006
肿瘤最大径	1.576	0.713~3.486	0.261
红细胞	0.295	0.070~1.124	0.077
血红蛋白	0.954	0.905~1.002	0.063
白细胞	0.684	0.395~1.069	0.141
血小板	1.000	0.989~1.009	0.944
凝血酶原时间	0.559	0.236~1.055	0.139
凝血酶时间	1.795	0.974~3.530	0.070
活化部分凝血活酶时间	0.892	0.757~1.014	0.119
纤维蛋白原	1.001	0.997~1.005	0.635
谷丙转氨酶	0.908	0.805~0.991	0.071
谷草转氨酶	0.954	0.834~1.057	0.433
总胆红素	0.968	0.830~1.089	0.630
肌酐	0.988	0.953~1.017	0.484

变量	单因素Logistic回归分析
变量	OR	95%CI	P值
年龄	1.070	1.002~1.142	0.043
性别	2.120	0.271~16.576	0.474
BMI	0.806	0.616~1.054	0.115
肿瘤数量	2.705	1.334~5.485	0.006
肿瘤最大径	1.576	0.713~3.486	0.261
红细胞	0.295	0.070~1.124	0.077
血红蛋白	0.954	0.905~1.002	0.063
白细胞	0.684	0.395~1.069	0.141
血小板	1.000	0.989~1.009	0.944
凝血酶原时间	0.559	0.236~1.055	0.139
凝血酶时间	1.795	0.974~3.530	0.070
活化部分凝血活酶时间	0.892	0.757~1.014	0.119
纤维蛋白原	1.001	0.997~1.005	0.635
谷丙转氨酶	0.908	0.805~0.991	0.071
谷草转氨酶	0.954	0.834~1.057	0.433
总胆红素	0.968	0.830~1.089	0.630
肌酐	0.988	0.953~1.017	0.484

组别	例数	年龄[岁，(±s)]	性别(例)		BMI[kg/m²，(±s)]	肿瘤数量[个，(±s)]	肿瘤最大径[cm，(±s)]	复发评分[分，(±s)]
组别	例数	年龄[岁，(±s)]	男	女	BMI[kg/m²，(±s)]	肿瘤数量[个，(±s)]	肿瘤最大径[cm，(±s)]	复发评分[分，(±s)]
高凝血酶原时间(>12.1 s)组	23	68.73±9.58	22	1	23.41±2.31	1.70±0.82	1.98±0.70	4.17±2.96
低凝血酶原时间(≤12.1 s)组	49	64.77±10.62	39	10	23.54±2.51	1.55±0.77	1.84±0.77	3.10±2.84
统计值		t=1.587	-		t=-0.179	t=0.711	t=0.754	t=1.558
P值		0.119	0.093		0.859	0.481	0.455	0.127
组别	病理分期(例)			病理分级(例)			尿pH[(±s)]	尿比重[(±s)]
组别	T₁	T_a	T_2a	高级别	低级别	具低度恶性潜能的乳头状尿路上皮肿瘤	尿pH[(±s)]	尿比重[(±s)]
高凝血酶原时间(>12.1 s)组	15	6	2	16	7	0	6.13±0.94	1.02±0.01
低凝血酶原时间(≤12.1 s)组	37	12	0	18	28	3	5.88±0.61	1.02±0.01
统计值	-			-			t=1.175	t=0.004
P值	0.128			0.028			0.249	0.997
组别	红细胞[×10¹²/L，(±s)]	血红蛋白[g/L，(±s)]	白细胞[×10⁹/L，(±s)]	血小板[×10⁹/L，(±s)]	凝血酶时间[s，(±s)]	活化部分凝血活酶时间[s，(±s)]
高凝血酶原时间(>12.1 s)组	4.21±0.56	128.57±13.88	11.41±3.85	184.61±45.16	16.73±1.00	31.43±6.23
低凝血酶原时间(≤12.1 s)组	4.33±0.43	132.96±12.97	10.29±3.06	219.08±69.75	16.58±1.00	25.84±3.94
统计值	t=-0.946	t=-1.279	t=1.219	t=-2.515	t=0.580	t=3.956
P值	0.351	0.208	0.231	0.014	0.565	<0.001

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