scholarly journals The values of neutrophil-lymphocyte ratio and/or prostate-specific antigen in discriminating real Gleason score ≥ 7 prostate cancer from group of biopsy-based Gleason score ≤ 6

BMC Cancer ◽  
2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Hanfeng Wang ◽  
Liangyou Gu ◽  
Yongjie Wu ◽  
Dan Feng ◽  
Junyao Duan ◽  
...  
2020 ◽  
Author(s):  
Sat Prasad Nepal ◽  
Takehiko Nakasato ◽  
Yoshio Ogawa ◽  
Yoshihiro Nakagami ◽  
Takeshi Shichijo ◽  
...  

Abstract Background: Many patients undergo unwanted prostate biopsy due to unreliability of prostate-specific antigen (PSA). PSA density (PSAD), free PSA, free-to-total PSA ratio, prebiopsy MRI are used to diagnose prostate cancer (PCa). Since 1863, correlations between inflammation and cancer have been identified and explored; thus, the role of various blood parameters in detecting cancer has been studied, especially neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Here, we evaluated whether these parameters before prostate biopsy can diagnose prostate cancer in our hospital.Methods: We conducted a retrospective study from January 2014 to January 2018. Prostate cancer patients were divided into significant cancer (Gleason Score ≥ 7) and insignificant cancer (Gleason Score < 7). NLR, PLR, and other clinical parameters were taken before the prostate biopsy. We then analyzed the associations of NLR and PLR alone or with PSA, with significant prostate cancer. Results: We included 463 patients, of whom 60.3% (279) had prostate cancer and 75.6 % (211) had a Gleason score (GS) of ≥ 7. PSA and PSAD in the clinically significant prostate cancer patient group were around two times more than those in the insignificant prostate cancer group. PV, NLR, PLR, and combined markers were more in the GS ≥ 7 population group. PSA combined with PLR (PPLR) and PSA with NLR (PNLR) had better area under a curve (AUC) (0.732 and 0.730, resp.), with statistical significance, than PSA, NLR, and PLR alone (0.723, 0.585, and 0.590). In the multivariate analysis using separate models with PSA and NLR or PLR compared to age, DRE-positive lesions, PV, PSAD; PNLR, and PPLR were statistically significant in finding aggressive prostate cancer. When combined markers were used together, despite the high correlations, PSA and NLR were nearly significant (p = 0.062) in detecting the GS ≥ 7 population.Conclusion: The combined use of PSA with PLR and PSA with NLR helps detect the differences between clinically significant and insignificant prostate cancer.


2015 ◽  
Vol 9 (11-12) ◽  
pp. 761 ◽  
Author(s):  
Mehmet Ilker Gokce ◽  
Nurullah Hamidi ◽  
Evren Suer ◽  
Semih Tangal ◽  
Adil Huseynov ◽  
...  

Introduction: We evaluate the role of NLR prior to prostate biopsy to predict biopsy histology and Gleason score in patients with prostate cancer.Methods: In this retrospective study, we evaluated data of patients underwent prostate biopsy between May 2005 and March 2015. We collected the following data: age, prostate-specific antigen (PSA), biopsy histology, Gleason score (GS) in prostate cancer patients, neutrophil counts, and lymphocyte counts. Patients were grouped as benign prostatic hyperplasia (BPH), prostate cancer, and prostatitis. The Chi square test was used to compare categorical variables and analysis of variance (ANOVA) was applied for continuous variables.Results: Data of 1836 patients were investigated. The mean age, total PSA and neutrophil-lymphocyte ratio (NLR) of the population were 66.8 ± 8.17 years, 9.38 ± 4.7 ng/dL, and 3.11 ± 1.71, respectively. Patients were divided as follows: 625 in the group with BPH history, 600 in the prostatitis group, and 611 in the prostate cancer histology group. The mean NLR of the prostatitis group was higher compared to the prostate cancer and BPH groups (p = 0.0001). The mean NLR of the prostate cancer group was significantly higher compared to the BPH group (p = 0.002). The GS 8–10 group had a significantly higher mean NLR compared to GS 5–6 (3.64 vs. 2.54, p = 0.0001) and GS 7 (3.64 vs. 2.58, p = 0.0001) patients.Conclusions: NLR was found to differ with regard to histology of prostate biopsy and higher GS was associated with higher NLR in patients with prostate cancer. However prostatitis prevents the use of NLR in predicting prostate cancer before a prostate biopsy. Also, the retrospective nature and lack of multivariate analysis in this study somewhat limits the relevance of these results.


BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025161
Author(s):  
Mark Rezk ◽  
Ashish Chandra ◽  
Daniel Addis ◽  
Henrik Møller ◽  
Mina Youssef ◽  
...  

ObjectivesTo determine whetherETS-related gene(ERG) expression can be used as a biomarker to predict biochemical recurrence and prostate cancer-specific death in patients with high Gleason grade prostate cancer treated with androgen deprivation therapy (ADT) as monotherapy.MethodsA multicentre retrospective cohort study identifying 149 patients treated with primary ADT for metastatic or non-metastatic prostate cancer with Gleason score 8–10 between 1999 and 2006. Patients planned for adjuvant radiotherapy at diagnosis were excluded. Age at diagnosis, ethnicity, prostate-specific antigen and Charlson-comorbidity score were recorded. Prostatic tissue acquired at biopsy or transurethral resection surgery was assessed for immunohistochemical expression ofERG. Failure of ADT defined as prostate specific antigen nadir +2. Vital status and death certification data determined using the UK National Cancer Registry. Primary outcome measures were overall survival (OS) and prostate cancer specific survival (CSS). Secondary outcome was biochemical recurrence-free survival (BRFS).ResultsThe median OS of our cohort was 60.2 months (CI 52.0 to 68.3).ERGexpression observed in 51/149 cases (34%). Multivariate Cox proportional hazards analysis showed no significant association betweenERGexpression and OS (p=0.41), CSS (p=0.92) and BRFS (p=0.31). Cox regression analysis showed Gleason score (p=0.003) and metastatic status (p<1×10-5) to be the only significant predictors of prostate CSS.ConclusionsNo significant association was found betweenERGstatus and any of our outcome measures. Despite a limited sample size, our results suggest thatERGdoes not appear to be a useful biomarker in predicting response to ADT in patients with high risk prostate cancer.


1997 ◽  
Vol 15 (4) ◽  
pp. 1465-1469 ◽  
Author(s):  
A V D'Amico ◽  
R Whittington ◽  
S B Malkowicz ◽  
D Schultz ◽  
J E Tomaszewski ◽  
...  

PURPOSE A multivariable analysis to evaluate the potential clinical and pathologic factors that predict for early biochemical failure in patients with pathologically organ-confined and margin-negative disease was performed to define patients who may benefit from adjuvant therapy. PATIENTS AND METHODS Three hundred forty-one prostate cancer patients treated with a radical retropubic prostatectomy between January 1989 and June 1995 and found to have pathologically organ-confined and margin-negative disease comprised the study population. A logistic regression multivariable analysis to evaluate the predictive value of the preoperative prostate-specific antigen (PSA) level, pathologic (prostatectomy) Gleason score, and pathologic stage on PSA failure occurring during the first postoperative year was performed. RESULTS Predictors of PSA failure during the first postoperative year in patients with pathologically organ-confined disease included pathologic Gleason score > or = 7 (P = .0007) and preoperative PSA level greater than 10 (P < .0001). Corresponding 3-year freedom-from-PSA-failure rates for these pathologic organ-confined patients with both, one, or neither of these factors were 60%, 75% to 84%, and 95%, respectively (P < .0001). CONCLUSION Prostate cancer patients with pathologically organ-confined and margin-negative disease and a preoperative PSA level greater than 10 ng/mL or a pathologic Gleason score > or = 7 have significant decrements in short-term PSA-failure-free survival. Therefore, these patients should be considered for adjuvant therapy in the setting of a phase III clinical trial.


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