Value of the Nomogram model based on hTERT and UCA1 expression in peripheral blood for predicting disease-free survival in elderly patients with bladder urothelial carcinoma after surgery

Objective: To investigate the value of the Nomogram model based on perioperative data, human pe-ripheral blood telomerase reverse transcriptase (hTERT) and uroepithelial carcinoma antigen 1 (UCA1) for pre-dicting disease-free survival in elderly patients with bladder urothelial carcinoma after surgery.Methods: A total of 268 elderly patients with bladder urothelial carcinoma admitted to Beijing Friendship Hospital, Capital Medi-cal University from April 2017 to April 2019, all of whom underwent radical cystectomy, were selected and ran-domly divided into modeling and validation populations, and were divided into death and survival groups accord-ing to 3-year disease-free survival rate after surgery.General and perioperative data of the two groups were com-pared.Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was used to detect hTERT and UCA1 gene expression in peripheral blood.Lasso and Cox regression equations were used to analyze the factors affecting disease-free survival in elderly patients with bladder uroepithelial carcinoma after surgery.The Nomo-gram model was constructed, and receiver operating characteristic (ROC) curve, calibration curve and decision curve were drawn to analyze the predictive performance.Results: The 3-year disease-free survival rate after sur-gery was 55.77% .The expression of hTERT and UCA1 in peripheral blood, ureteral incisal margin, age, tumor stage and lymph node metastasis were all influencing factors for disease-free survival in elder-ly patients with bladder urothelial carcinoma after surgery (all P< 0.05).The C-index of the Nomogram model constructed based on the above factors was 0.857 and 0.949 in the modeling population and the verification popu-lation, respectively.After calibration curve analysis, the predicted net benefit value of this model was higher in the range of 0.2-1.0 and 0.1-1.0 in the modeling population and the verification population.Conclusion: The high expression of hTERT and UCA1 in peripheral blood is a risk factor for disease-free survival in elderly pa-tients with bladder urothelial carcinoma after surgery.The constructed model has certain predictive value for dis-ease-free survival of patients after surgery.