Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Alone or Combined with Prostate-Specific Antigen for the Diagnosis of Clinically Significant Prostate Cancer

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.

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The neutrophil-to-lymphocyte ratio at the prostate-specific antigen nadir predicts the time to castration-resistant prostate cancer

Asian Journal of Urology ◽

10.1016/j.ajur.2020.05.006 ◽

2020 ◽

Author(s):

Genta Iwamoto ◽

Takashi Kawahara ◽

Yumiko Yokomizo ◽

Yasuhide Miyoshi ◽

Masahiro Yao ◽

...

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Specific Antigen ◽

Neutrophil To Lymphocyte Ratio ◽

Castration Resistant Prostate Cancer ◽

Lymphocyte Ratio ◽

Castration Resistant

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Can we use neutrophil to lymphocyte ratio in the diagnosis and prediction of extracapsular extension in localized prostate cancer?

Urologia Journal ◽

10.1177/03915603211014864 ◽

2021 ◽

pp. 039156032110148

Author(s):

Erkan Merder ◽

Ahmet Arıman ◽

Selvi Dinçer ◽

Fatih Altunrende

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Prostate Specific Antigen ◽

Specific Antigen ◽

Neutrophil To Lymphocyte Ratio ◽

Localized Prostate Cancer ◽

Extracapsular Extension ◽

Lymphocyte Ratio ◽

Pathologic Stage ◽

Free Psa

Purpose: We investigated role of neutrophil-to-lymphocyte ratio (NLR) in the diagnosis and prediction of extracapsular extension (ECE) in clinically localized prostate cancer (PCa). Materials and methods: A total of 396 patients with clinically localized PCa who underwent open radical retropubic prostatectomy (RRP), and 260 patients with benign prostatic hyperplasia (BPH) who underwent suprapubic prostatectomy were included in the study. Preoperative NLR, prostate specific antigen (PSA), prostate specific antigen density (PSAD), free PSA, prostate volume (PV), free/total PSA (f/t PSA) in both groups, and relation of NLR with PSA, Gleason Score (GS), and pathologic stage in PCa group were investigated. Records of patients were analyzed retrospectively. Results: NLR, free PSA, f/t PSA, and PV were statistically higher in BHP, and PSAD was higher in PCa group. In PCa group, NLR was found to be higher in patients with PSA >10 ng/ml compared to those with less than ⩽10 ng/ml. NLR increases as the preoperative GS increases, and it was higher in pT3 patients than pT2 patients. NLR was statistically higher in those patients with positive lymph nodes than those without after RRP ( p = 0.029). Conclusion: NLR is not a sufficient biomarker in differentiating clinically localized PCa from BPH. NLR increases as preoperative GS and pathologic stage increases. Lymph node involved patients after RRP have statistically higher NLR. NLR can be an indicator of ECE and lymph-node involvement in clinically localized PCa.

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The role of blood neutrophil count and the neutrophil-to-lymphocyte ratio as a predictive factor for prostate biopsy results

Urologia Journal ◽

10.1177/0391560318766822 ◽

2018 ◽

Vol 85 (4) ◽

pp. 158-162 ◽

Cited By ~ 1

Author(s):

Koosha Kamali ◽

Mojtaba Ashrafi ◽

Pejman Shadpour ◽

Mojtaba Ameli ◽

Amirmahdi Khayyamfar ◽

...

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Neutrophil Count ◽

Prostate Biopsy ◽

Predictive Factor ◽

Specific Antigen ◽

Digital Rectal Examination ◽

Neutrophil To Lymphocyte Ratio ◽

Blood Neutrophil ◽

Lymphocyte Ratio

Background: It is apparent that prostate cancer has harmful effects on the erythrocytes, leucocytes, and platelets. In addition, it has been suggested that the toxic granules in neutrophils lead to inflammation in the cancerous tissues besides the activation of monocytes, so in this study we aimed to evaluate the blood neutrophil count besides the neutrophil-to-lymphocyte ratio as a predictive factor for prostate biopsy results and their relationship with prostate cancer grade in patients undergoing biopsy of the prostate. Methods: For all men with irritative lower urinary tract symptoms visiting Hasheminezhad Hospital from January to July 2015, in case of having a suspicious digital rectal examination or aged above 40 years, prostate-specific antigen was requested and in case of abnormal results, they underwent prostate biopsy. In order to examine the study hypothesis, the blood neutrophil count and the neutrophil-to-lymphocyte ratio were measured and compared with the abnormal prostate-specific antigen results and suspicious digital rectal examination. Results: Among the 500 referred samples for biopsy, 352 (70.4%) had a negative biopsy result, while it was positive in the other 148 (29.6). The mean neutrophil count showed no statistical difference regarding the biopsy results (p = 0.381). When measuring the neutrophil-to-lymphocyte ratio again with biopsy results, no statistically significant difference was obtained based on the biopsy results (p = 0.112). Conclusion: Neutrophil count and neutrophil-to-lymphocyte ratio cannot be predictive factors for positive prostate cancer biopsy.

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