scholarly journals Evaluation of neutrophil-to-lymphocyte ratio prior to prostate biopsy to predict biopsy histology: Results of 1836 patients

2015 ◽  
Vol 9 (11-12) ◽  
pp. 761 ◽  
Author(s):  
Mehmet Ilker Gokce ◽  
Nurullah Hamidi ◽  
Evren Suer ◽  
Semih Tangal ◽  
Adil Huseynov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Categorical Variables ◽  
Chi Square ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Cancer Group ◽  
The Mean

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.

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

2020 ◽  
Author(s):  
Sat Prasad Nepal ◽  
Takehiko Nakasato ◽  
Yoshio Ogawa ◽  
Yoshihiro Nakagami ◽  
Takeshi Shichijo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Gleason Score ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Diagnose Prostate Cancer ◽  
Clinically Significant ◽  
Insignificant 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.

scholarly journals Correlation between Prostate Specific Antigen and Prostate Biopsy Gleason Score

2019 ◽  
pp. 243-248
Author(s):  
PE Ngwu ◽  
GO Achor ◽  
VU Eziefule ◽  
JI Orji ◽  
FT Alozie
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Gleason Score ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Positive Correlation ◽  
Cancer Management ◽  
The Mean ◽  
High Level

Background: Prostate Specific Antigen (PSA) is a commonly used marker in prostate cancer management. Gleason grading is one of the most powerful predictors of prostatic biological behaviour. PSA, when combined with the Gleason score and clinical stage, improves the prediction of the pathological stage for prostate cancer. Objectives: To assess the degree of correlation between PSA level and Gleason score as well as determine the likelihood of aggressiveness of prostate cancer using Gleason score as a parameter. Methods: A cross-sectional prospective study was conducted among 234 consecutive consenting patients presenting to the Urology Out-Patient Clinic between April 2015 and March 2018. Serum PSA was done and patients with values above 4ng/ml and/or abnormal Digital Rectal Examination (DRE) were selected to have a prostate biopsy. The sample was histologically analysed with Gleason score recorded for those with prostate cancer. Gleason score was then correlated with PSA levels. Results: The mean age for prostate cancer patients was 71.3±8.7 years. The mean PSA for patients with prostate cancer was 52.3±37.5ng/ml (Confidence Interval = 46.1-58.6) with p<0.001. About 18.2% of histologically confirmed prostate cancer cases had Gleason score 8-10 implying a high level of tumour aggressiveness. There is a positive correlation between PSA and Gleason score with R-value 0.590 indicating a good degree of correlation. Conclusion: There is a good degree of a positive correlation between PSA level and Gleason score, as well as a high level of aggressiveness of prostate cancer in Umuahia.

Gleason score upgrade among 10,282 men who underwent surgery as initial treatment in 2010: A population-based study.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 72-72
Author(s):  
Hong Zhang ◽  
Edward M. Messing ◽  
Hamza Ahmed ◽  
Yuhchyau Chen
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Gleason Score ◽  
Specific Antigen ◽  
Low Risk ◽  
Categorical Variables ◽  
Intermediate Risk ◽  
Time Of Surgery ◽  
Significant Difference ◽  
Risk Prostate Cancer

72 Background: Active surveillance is now accepted initial management for men who have localized prostate cancer with low risk of disease progression. Many criteria have been used for patient identification, including Gleason score (GS) obtained from prostate biopsy. Because of concerns of sampling error, some have recommended repeated biopsy before committing to active surveillance. However, there is limited information about the risk of missing high grade disease using the current standard biopsy approach. This study seeks to compare GS difference from biopsy and surgery to provide an estimated rate of GS upgrade. Methods: The Surveillance, Epidemiology, and End Results (SEER) program was used to identify men with American Joint Committee on Cancer stage T1-2cN0M0 prostate cancer diagnosed between January 2010 and December 2010. Patients who underwent prostatectomy were selected for further analysis. Based on prostate-specific antigen (PSA) levels and GS, cases were divided into low (PSA <=10 and GS <=6) and intermediate (10<PSA<=20 or GS=7) risk groups. The rates of GS upgrade were reported for each group. Chi-square tests were used to assess differences in categorical variables (e.g. age and race) between groups of GS upgrade and no change/downgrade. Results: A total of 10,282 men were evaluated, with 9.2% (n=942) having low-risk disease, and 90.8% (n=9340) having intermediate-risk disease. Among men with low-risk prostate cancer, 22.3% (n=210) had GS upgrade and 0.8% (n=8) had GS 8 disease. Among men with intermediate risk disease, 26.2% (n=2446) had GS upgrade and 2.3% (n=214) had GS 8 disease. There was no statistically significant difference in either age or race distribution among men who had GS upgrade versus no change or downgrade at the time of surgery. Conclusions: A substantial number of low- and intermediate-risk prostate cancer patients had GS upgrade at the time of surgery, but few had upgraded to GS 8 high risk disease. These observations suggest that repeat biopsy prior to active surveillance may not be necessary.

scholarly journals Needle biopsy size and pathological Gleason Score diagnosis: No evidence for a link

2013 ◽  
Vol 7 (9-10) ◽  
pp. 567 ◽  
Author(s):  
Antonio Cicione ◽  
Francesco Cantiello ◽  
Cosimo De Nunzio ◽  
Andrea Tubaro ◽  
Rocco Damiano
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Kappa Statistic ◽  
Study Groups ◽  
Localized Prostate Cancer ◽  
Needle Size ◽  
Biopsy Needle ◽  
Biopsy Gleason Score

Background: Biopsy Gleason score (GS), in combination with other clinical parameters, is important to take a therapeutic decision for patients with diagnosis of localized prostate cancer. However, preoperative GS is often upgraded after a radical prostatectomy. Increasing the amount of tissue in prostate biopsy may be a way to avoid this issue. We evaluate the influence of a larger biopsy needle size on the concordance between biopsy and pathological GS.Methods: We analyzed paired biopsies and prostatectomy specimens from 104 cases of men with clinically localized prostate cancer. At the time of prostate biopsy, the patients were prospectively randomized into two needle groups (16-Gauge [G] and 18G) using a 1:1 ratio. GS concordance was estimated performing kappa statistic testing, overall concordance rate and risk to under grade biopsy GS=6. A logistic regression analysis was performed to evaluate the patients’ characteristics as possible risk factors.Results: The overall concordance between prostate biopsy and pathological GS was 76.9% and 75.6% (p = 0.875) and the k values were 0.821 and 0.811 (p = 0.424), respectively, for 16G and 18G needle study groups. The risk to undergrade a biopsy GS=6 was 21.1% and 15.4% (p = 0.709) using a 16G and 18G needle, respectively. Age, prostate-specific antigen, prostate volume and needle calibre were not independently associated with a higher risk of GS discordance.Conclusions: Needle size does not affect the concordance between biopsy and pathological GS. Although GS is not the only way to determine treatment, it is still an unresolved urological issue.

scholarly journals Pretreatment neutrophil-to-lymphocyte ratio and Mean Platelet Volume in castration-resistant prostate cancer patients treated with first-line docetaxel

2019 ◽  
Author(s):  
Barbaros Başeskioğlu ◽  
Berna Bozkurt Duman ◽  
Bülent Yıldız ◽  
Timuçin Çil ◽  
Murat Dinçer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Mean Platelet Volume ◽  
Specific Antigen ◽  
Phase Iii ◽  
Castration Resistant Prostate Cancer ◽  
Platelet Volume ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Castration Resistant ◽  
Psa Response

Abstract Background:Patients who have evidence of disease progression (eg, increase in serum prostate-specific antigen [PSA], new metastases, progression of existing metastases) while being managed with androgen deprivation therapy (ADT) are considered to have castration-resistant disease. Docetaxel (75 mg/m2) given every three weeks in combination with daily prednisone (5 mg twice a day) significantly prolonged overall survival compared with mitoxantrone plus prednisone in the TAX 327 phase III trial [3]. Based upon those results, docetaxel plus prednisone has become the standard initial regimen when chemotherapy is indicated for CRPC Methods: Inflammation-based markers, such as the Neutrophile/Lymphocyte Ratio (NLR), are widely available and inexpensive measurements that are easy to integrate into pretreatment evaluation. Mean platelet volume (MPV) is a marker of activated platelets is associated some types of cancer including ovarian, gastric cancer. We retrospectively evaluated the predictive impact of neutrophil-lymphocyte ratio (NLR) and MPV as a marker for in men with progressive metastatic castration resistant prostate cancer (mCRPC) following docetaxel.Results: A significant correlation was not observed between NLR and PSA response. A significant correlation was not also observed between MPV and PSA response.There no correlation was found between MPV and NLR with total PSA level and response (p:0.355, p:0.673 respectively)Conclusion: . In our study; We didn’t show any correlation between MWP level, NLR ratio and response to Docetaxel therapy A significant correlation was not also observed between NLR , MPV and PSA response.

scholarly journals Ar galima remiantis objektyviais ikioperaciniais veiksniais prognozuoti ankstyvą biocheminį atkrytį po radikalios prostatektomijos?

2005 ◽  
Vol 3 (4) ◽  
pp. 0-0
Author(s):  
Daimantas Milonas ◽  
Dainius Burinskas ◽  
Stasys Auškalnis ◽  
Mindaugas Jievaltas
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prostate Specific Antigen ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Biochemical Failure ◽  
Surgical Margins ◽  
Antigen Concentration ◽  
The Mean

Daimantas Milonas, Dainius Burinskas, Stasys Auškalnis, Mindaugas JievaltasKauno medicinos universiteto Urologijos klinika,Eivenių g. 2, LT-50009 KaunasEl paštas: [email protected] Tikslas Nustatyti objektyvius veiksnius, kurie leistų prognozuoti ankstyvą biocheminį atkrytį po radikalios prostatektomijos. Ligoniai ir metodai Į tyrimą įtraukti 142 prostatos vėžiu sergantys ligoniai, kuriems buvo atliktos radikalios prostatektomijos. Ankstyvas biocheminis atkrytis konstatuotas, kai prostatos specifinio antigeno koncentracija, praėjus 3 mėn. po operacijos, buvo >0,2 ng/ml. Neoadjuvantinė terapija (hormonų ar spindulių) buvo pagrindinis atmetimo kriterijus. Vertinta prostatos specifinio antigeno koncentracija, vėžio diferenciacijos laipsnis iki ir po operacijos, vėžio stadija, prostatos chirurginio šalinimo išlaidos. Rezultatai Galutinei analizei panaudoti 94 ligonų duomenys. Vidutinis jų amžius buvo 66,6 metų, prostatos specifinis antigenas iki operacijos – 9,87 ng/ml, Gleason diferenciacijos laipsnis iki operacijos – 5,87, diferenciacijos laipsnis po operacijos – 6,38, teigiami rezekciniai kraštai rasti 36 (38%), ankstyvas biocheminis atkrytis – 13 (14%) pacientų. Atlikus logistinę regresijos analizę nustatyta, jog ankstyvą biocheminį atkrytį galima patikimai prognozuoti, kai Gleason pooperacinis vėžio diferenciacijos laipsnis didesnis nei 7 (p = 0,02, tikimybių santykis – 7,8) ir vėžio stadija T3b (p = 0,012, tikimybių santykis – 6,76). Išvados Remiantis ikioperaciniais objektyviais veiksniais negalima patikimai prognozuoti ankstyvo biocheminio atkryčio. Prostatos vėžio išplitimas į sėklines pūsleles (T3b stadija) ir Gleasono pooperacinis vėžio diferenciacijos laipsnis > 7 leidžia reikšmingai prognozuoti ankstyvą biocheminį atkryti, po radikalios prostatektomijos, tokiems ligoniams indikuojamas ankstyvas adjuvantinis gydymas, nelaukiant biocheminio atkryčio požymių. Reikšminiai žodžiai: prostatos vėžys, radikali prostatektomija, ankstyvas biocheminis atkrytis Can objective preoperative parameters predict early biochemical recurrence after radical prostatectomy? Daimantas Milonas, Dainius Burinskas, Stasys Auškalnis, Mindaugas JievaltasClinic of Urology, Kaunas University of Medicine,Eivenių str. 2, LT-50009 Kaunas, LithuaniaE-mail: [email protected] Objective To estimate objective parameters which can be useful for predicting early biochemical recurrence after radical prostatectomy due to prostate cancer. Patients and methods The study embraced 142 patients that underwent radical retropubic prostatectomy. Early biochemical failure was defined as a prostate-specific antigen level 3 months after radical prostatectomy > 0.2 ng/ml. Neoadjuvant treatment (hormonal therapy or radiation) was the mane exclusion criteria. Preoperative antigen concentration, Gleason score at the biopsy, patients’ age, postoperative Gleason score, stage and surgical margins were investigated as possible predictors of early biochemical recurrence. Results Final analysis was done using data on 94 patients. The mean patients’ age was 66.6 years and mean preoperative prostate specific antigen concentration 9.87 (range 0.44–98.4) ng/ml. The mean Gleason score preoperatively was 5.87 (range 2–8) and postoperatively 6.38 (range 4–9). Positive surgical margins were in 36 (38%) and early biochemical failure was detected in 13 (14%) cases. Logistic regression analysis shows that postoperative Gleason score >7 (p = 0.02, OR-7.8) and stage pT3b (p = 0.012, OR-6.76) are powerful parameters for predicting early biochemical recurrence. Conclusions Preoperative parameters cannot predict early biochemical recurrence. Postoperative parameters such as Gleason score >7 and stage pT3b are useful in the prediction of early biochemical recurrence. In such patients early adjuvant treatment is advisable. Keywords: prostate cancer, radical prostatectomy, early biochemical recurrence

Patient characteristics at time of prostate cancer diagnosis in different races at an academic center serving a diverse population.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 158-158
Author(s):  
Tejas Suresh ◽  
Qi Gao ◽  
Mimi Kim ◽  
Sanjay Goel ◽  
Benjamin Adam Gartrell
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Metastatic Disease ◽  
Death Rate ◽  
Age At Diagnosis ◽  
Categorical Variables ◽  
Racial Groups ◽  
Diverse Population ◽  
Academic Center ◽  
The Mean

158 Background: In the United States, prostate cancer (PCa) incidence and death rate differ among racial groups. Non-Hispanic Blacks (NHB) have a higher incidence and death rate than non-Hispanic Whites (NHW), whereas incidence and death rate are slightly lower in Hispanics (H) than in NHW. We sought to compare the socioeconomic, demographic and baseline prognostic factors at PCa diagnosis among different races at a large, urban academic center serving a diverse population. Methods: Following institutional review board approval, the Montefiore Medical Center Cancer Registry was used to generate a comprehensive list of patients diagnosed with PCa 2004 to 2013. Clinical Looking Glass (a searchable database of patient information) and individual patient chart review were used to obtain data including age at diagnosis, socioeconomic score (SES), Gleason score, stage at diagnosis and PSA at diagnosis. Patients were classified by self-identified race as H, NHB or NHW. For categorical variables the chi-square test was used, whereas the ANOVA or the Kruskal-Wallis tests were employed for continuous variables. Results: During the specified period 2352 patients were diagnosed with PCa among which 778 were self-classified as H, 1046 as NHB, 486 as NHW and 42 as other (O). The mean age at diagnosis differed between these groups (H 63.2, NHB 63.4, NHW 67, O 63.0, p < 0.0001). The proportion of men below the mean SES also differed between races (H 92.8%, NHB 91.3%, NHW 56.6%, O 75%, p < 0.0001). Median PSA (ng/ml) at diagnosis was similar (H 8.0, NHB 8.4 NHW 7.2, O 6.4, p = 0.0768) whereas Gleason score differed between racial groups (Gleason ≤ 6: H 42.8%, NHB 39.1%, NHW 52.2%, O 50%; Gleason 8-10: H 15.8%, NHB 17.6%, NHW 14.3%, O 16.7%, p = 0.0005). The proportion of men with metastatic disease at diagnosis also differed significantly in these groups (H 7.5%, NHB 9.0%, NHW 4.3%, O 9.5%, p = 0.0139). Conclusions: At our center, in patients with newly diagnosed PCa, there are significant differences among racial groups. These include age at diagnosis, SES, Gleason score and proportion with metastatic disease. Such differences at diagnosis suggest that minority patients are at risk for inferior PCa outcomes.

scholarly journals The Impact of Pathologic Upgrading of Gleason Score 7 Prostate Cancer on the Risk of the Biochemical Recurrence after Radical Prostatectomy

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Juhyun Park ◽  
Sangjun Yoo ◽  
Min Chul Cho ◽  
Min Hyun Cho ◽  
Chang Wook Jeong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Mean ◽  
The Impact

Objective. To investigate the impact of pathologic upgrading of Gleason score (GS) 7 prostate cancer on the risk of the biochemical recurrence. Materials and Methods. A total of 1678 patients with postoperative GS 7 prostate cancer without lymph node metastasis were reviewed retrospectively. The patients were categorized into four groups depending on pathologic upgrading: upgraded GS 3+4, nonupgraded GS 3+4, upgraded GS 4+3, and nonupgraded GS 4+3. Kaplan-Meier multivariate model was created. Results. The mean age was significantly higher in the nonupgraded GS 4+3 group than in other groups, whereas the mean prostate-specific antigen (PSA) level was lower in the upgraded GS 3+4 group. Pathologic findings, such as extracapsular extension, seminal vesical invasion, and the surgical margin rate, were different from each other. Five-year biochemical recurrence-free survival rate was 85%, 73%, 69%, and 60% in upgraded GS 3+4, nonupgraded GS 3+4, upgraded GS 4+3, and nonupgraded GS 4+3 group, respectively. There was significant difference between the nonupgraded 4+3 and upgraded 4+3 group, as well as between upgraded 3+4 and nonupgraded 3+4 group. However, the two middle patient groups, that is, the nonupgraded GS 3+4 group and the upgraded GS 4+3 group, did not show the statistical difference (Log-rank test, p value = 0.259). Conclusion. The information on pathologic upgrading in the biopsy reports of patients could help to provide more detailed analysis for the biochemical recurrence of GS 7 prostate cancer.

Predictors of ISUP score upgrade in patients with low-risk prostate cancer

2020 ◽  
pp. 030089162094395
Author(s):  
Hakan Bahadir Haberal ◽  
Meylis Artykov ◽  
Berk Hazir ◽  
Burak Citamak ◽  
Mesut Altan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Low Risk ◽  
Extension Rate ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Psa Density ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

Introduction: The literature contains few studies that focus on the relationship between International Society of Urological Pathology (ISUP) score upgrade and complete blood count (CBC) parameters for patients with low-risk prostate cancer and studies achieved inconclusive results. Methods: We retrospectively analyzed our institutional database for patients with prostate cancer who underwent radical prostatectomy (RP) between 1994 and 2017. In total, we included 633 patients with low-risk prostate cancer in the study. We investigated the effects of clinicopathologic factors on ISUP score upgrade. Moreover, we compared RP pathologic outcomes between the patients with and without ISUP score upgrade. Results: The mean age and follow-up periods were 61.09±6.61 years and 41.9±1.8 months, respectively. ISUP score upgrade was observed in 207 patients (32.7%). In multivariate analysis, high prostate-specific antigen (PSA) density and percentage of positive cores were found to be significantly associated with ISUP score upgrade ( p = 0.003 and p = 0.003, respectively). The neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, monocyte–lymphocyte ratio, and eosinophil–lymphocyte ratio were found to have no effect on ISUP score upgrade ( p = 0.856, p = 0.353, p = 0.128, and p = 0.074, respectively). The percentage of tumors, surgical margin positivity, seminal vesicle invasion rate, and extraprostatic extension rate in RP pathology were higher in patients with ISUP score upgrade ( p < 0.001, p < 0.001, p < 0.001, and p < 0.001, respectively). Conclusions: Approximately one-third of the patients in our series had ISUP score upgrade in RP pathology. PSA density and the percentage of positive cores were found to be the factors significantly associated with ISUP score upgrade. CBC-related factors had no effect on ISUP score upgrade.

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