| Objective:To explore whether peripheral blood neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),C-reactive protein(CRP),α1-acid glycoprotein(AAG),fibrinogen(FBG)and D-dimer are risk factors for prostate cancer(PCA)before transrectal ultrasound-guided prostate biopsy in clinic,and to evaluate its predictive value in the prediction of the incidence of prostate cancer(PCA).Methods:The patients who received transrectal ultrasound-guided prostate biopsy in Affiliated Hospital of Qinghai University from November 2017 to November 2020 were selected.The difference of general clinical data between PCA group and BPH group was statistically analyzed to screen out the risk factors of PCA.Comparing the difference of clinical data between PCA bone metastasis group and non bone metastasis group to screen the risk factors of PCA bone metastasis.The correlation of clinical parameters with pathological grade and clinical prognosis stage of PCA was analyzed.Evaluating the clinical value of each index and the new prediction model in predicting PCA.Result:(1)Clinical indicators were compared between the two groups,the results show that NLR、PLR and D-dimer in PCA group were significantly higher than those in the control group(P<0.0001).There was no statistical significance of the CRP,α1-acid glycoprotein and FBG values between the two groups(P=0.694,P=0.089 and P=0.433).(2)The significant variables in univariate analysis were analyzed by binary logistic regression,the results show that NLR(OR=2.551,P=0.001)and PLR(OR=1.008,P=0.04)were independent risk factors for PCA.(3)The level of NLR was positively correlated with the pathological grade of PCA(r=0.218,P<0.05);The level of NLR was positively correlated with the clinical stage of PCA(r=0.306,P<0.05).PLR has no significant correlation(P>0.05).(4)The levels of NLR,D-dimer and t PSA in PCA bone metastasis group were significantly different from those in non-metastasis group(P<0.05),and those in bone metastasis group were higher than those in non-metastasis group.There were no significant differences in age,PLR,CRP,α1-acid glycoprotein and FBG between the two groups(P>0.05).However,after multivariate logistic analysis,except t PSA,NLR and D-dimer cannot be used as independent risk factors for bone metastasis.(5)The area under the curve of PCa was predicted by ROC curve analysis of NLR,PLR,t PSA and the combined index.The AUC of NLR is 0.741(95%CI:0.685-0.798,P<0.0001),the sensitivity was 64.0% and the specificity was 76.2%;the AUC of PLR was 0.709(95%CI: 0.651-0.767,P<0.0001),the sensitivity was 54.7%,and the specificity was 75.5%.The AUC of t PSA is 0.863(95%CI: 0.820-0.906,P<0.0001),the sensitivity is 78.4%,and the specificity is 82.8%;Using t PSA alone to predict PCa has the highest accuracy.The AUC of the combined index(t PSA+NLR+PLR)is 0.896(95%CI: 0.861-0.932,P<0.0001),the sensitivity is 74.1%,and the specificity is 93.4%,which is higher than the AUC of PCa predicted by t PSA alone.There is statistical significance(P=0.042).Although the AUC of the new prediction model is higher than that of TPSA alone,its sensitivity is slightly lower.The new prediction model(TPSA + NLR + PLR)has the same value as TPSA in predicting the risk of PCA.Conclusions:(1).NLR and PLR are independent risk factors for the risk of PCa.The higher the level of NLR and PLR,the higher the risk of PCa;(2).NLR can be used as an index to judge the degree of malignancy and clinical progress of PCA.The higher the level of NLR,the higher the degree of malignancy,the later the stage and the worse the prognosis of PCA;(3).The levels of NLR,D-dimer and t PSA in PCA bone metastasis group were significantly higher than those in non bone metastasis group.Except t PSA,NLR and D-dimer cannot be used as independent risk factors for bone metastasis;(4).Compared with NLR and PLR,TPSA has the highest accuracy in predicting PCA.The new prediction model composed of TPSA + NLR +PLR has the same value as TPSA alone in predicting the risk of PCA. |
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