Study On The Role Of P2PSA And Its Derivatives Combined With NLR In The Diagnosis Of Prostate Cancer

Objective To explore [-2] Pro-Prostate-Specific Antigen(p2PSA)and its derivatives,Prostate Health Index(PHI)and Percentage [-2] Pro-Prostate-Specific Antigen(%p2PSA)combined with Neutrophil to Lymphocyte Ratio(NLR)in the diagnosis of prostate cancer.Methods 48 patients with prostate cancer and 44 patients with non-prostate cancer who were diagnosed by prostate biopsy from Tangshan Workers Hospital of North China University of Technology from February 2019 to January 2020 were selected.Routine detection of blood routine,total prostate specific antigen(tPSA),freePSA(fPSA),freePSA and totalPSA ratio(f/tPSA),using enzyme-linked immunoassay to detect the serum p2PSA of the enrolled patients,using the formula to calculate prostate specific antigen density(PSAD),NLR,%p2PSA,PHI.Observe and compare the difference between prostate cancer and non-prostate cancer patients whenPSA is between 4 and 10ng/ml.Statistical software was used to analyze whether there were statistical differences in age,tPSA,fPSA,f/tPSA,PSAD,p2PSA,%p2PSA,PHI,NLR and other indicators between the two groups of patients with prostate cancer and non-prostate cancer whenPSA > 10ng/ml.The Spearman correlation analysis was used to explore the relationship between p2PSA,%p2PSA,PHI,NLR and other indicators and prostate cancer Gleason score.Draw the ROC curve of tPSA,fPSA,f/tPSA,PSAD,p2PSA,%p2PSA,PHI,NLR to diagnose prostate cancer,determine the cutoff value according to the Yoden index,compare the area under the curve,sensitivity and specificity;further draw tPSA,NLR,p2PSA,%p2PSA,PHI and NLR combined with p2PSA,%p2PSA,and PHI to diagnose the ROC curve of prostate cancer,comparing the area under the curve,sensitivity and specificity.At the same time,draw the ROC curve of tPSA,fPSA,f/tPSA,PSAD,p2PSA,%p2PSA,PHI,NLR single diagnosis of prostate cancer Gleason score ≥7 points,determine the cutoff value according to the Youden index,compare the area under the curve,sensitivity Specificity;further plot the ROC curve of tPSA,NLR,p2PSA,%p2PSA,PHI and NLR combined with p2PSA,%p2PSA,PHI to diagnose prostate cancer Gleason score ≥7 points,and compare the area under the curve,sensitivity and specificity.Results When the serumPSA was between 4 and 10ng/ml,the p2PSA,%p2PSA,PHI,and NLR of 2 patients with prostate cancer were higher than 10 non-prostate cancer patients.When serumPSA>10ng/ml,tPSA,p2PSA,%p2PSA,PHI,NLR were statistically significantly different between the two groups(P<0.05).The area under the ROC curve for the diagnosis of prostate cancer by tPSA,fPSA,f/tPSA,PSAD,p2PSA,%p2PSA,PHI,NLR and NLR combined with p2PSA,NLR combined with %p2PSA,NLR combined with PHI is: 0.727,0.582,0.318,0.602,0.746,0.709,0.834,0.789,0.831,0.816,0.866.Among them,the area under the curve of p2PSA,%p2PSA,PHI combined with NLR was further increased compared with the single index.The best cutoff values for p2PSA,%p2PSA,PHI and NLR are: 28.23pg/ml,1.00,52.78,and 2.35,and the corresponding sensitivities are: 61.3%,73.9%,69.6%,and 69.6%;the specificities are: 88.2%,61.8%,82.4%,79.4%.The sensitivity of NLR combined with p2PSA,NLR combined with %p2PSA,and NLR combined with PHI in the diagnosis of prostate cancer were: 65.2%,67.4%,and 65.2%,and the specificities were: 88.2%,88.2%,and 97.1%,respectively.The tPSA,fPSA,p2PSA,%p2PSA,PHI,and NLR were statistically significantly different in prostate cancer Gleason score ≤6 and ≥7(P<0.05).Gleason score is positively correlated with p2PSA,%p2PSA,PHI,NLR and other indicators.The area under the ROC curve of the tPSA,fPSA,f/tPSA,PSAD,p2PSA,%p2PSA,PHI,NLR and NLR combined with p2PSA,NLR combined with %p2PSA,NLR combined with PHI diagnosis of prostate cancer Gleason score ≥7 points were 0.669,0.623,0.446,0.774,0.646,0.827,0.728,0.804,0.764,0.848.Among them,the area under the curve of p2PSA,%p2PSA,PHI combined with NLR was further increased compared with the single index.The best cut-off values for p2PSA,%p2PSA,PHI,and NLR are 31.92pg/ml,1.38,59.62,and 2.70,and the corresponding sensitivities are: 63%,51.9%,85.2%,and 48.1%;and the specificities are: 90.5%,90.5%,95.2%,76.2%.NLR combined with p2PSA,NLR combined with %p2PSA,NLR combined with PHI for diagnosis of prostate cancer Gleason score ≥7 points Sensitivity were: 74.1%,63%,96.3%;specificity were: 90.5%,90.5%,76.2%.Conclusions 1 When the serumPSA>10ng/ml,the value of p2PSA,PHI,NLR in the diagnosis of prostate cancer is better than the traditional index tPSA.2 When the serumPSA>10ng/ml,the value of p2PSA,PHI,%p2PSA combined with NLR in the diagnosis of prostate cancer is further improved,better than the single indicators p2PSA,PHI,%p2PSA,NLR,and even better than the traditional indicator tPSA.3 The value of p2PSA,PHI,NLR in the diagnosis of aggressive prostate cancer is also superior to the traditional index tPSA.4 The value of p2PSA,%p2PSA,and PHI combined with NLR in the diagnosis of aggressive prostate cancer has been further improved,better than the single index p2PSA,%p2PSA,PHI,NLR,and even better than the traditional index tPSA.Figure4;Table8;Reference 87...