| Objective: By analyzing the clinical datas of 820 patients who had transrectal prostate biopsy,this paper attempts to figure out the correlation between NLR,PLR and PCa in diagnosis,treatment and prognosis of patients with prostatic carcinoma(PCa)so as to obtain the biochemical indexes that can be used effectively to predict the screening,diagnosis,treatment and prognosis of PCa in addition to PSA,thus improving the accuracy of PCa diagnosis,reducing unnecessary inspections,then developing a reliable risk assessment system for PCa patients.Methods: It can be concluded that this paper based on a retrospective analysis on the clinical data of patients who underwent transrectal prostate biopsy in urology department in our hospital from January 2010 to December 2017.Specifically speaking,one can be clarified as to collect the NLR and PLR values of pre-puncture of paients before they operated radical prostatectomy(Radical prostatectomy,RP)and endocrine treatment;the other is to analyze differences on the screening,diagnosis,treatment and prognosis of PCa patients from varied groups by calcutating the maximum cut-off value in via of receiver operating characteristic(ROC)curve and Youden's index.In addition,Kaplan-Meier method was used to compare the differences of castration resistant progression free survival,biochemical recurrence free survival between different PLR and NLR groups and the uni-variate and multivariate Cox regression models to analyze the independent risk factors of PCa.Results: According to the inclusion criteria of this study,702 cases were included.Among them,409 cases of benign prostatic hyperplasia(BPH)and 293 cases of PCa,of which 117 cases were RP patients and 176 cases were endocrine therapy patients.102 patients with radical prostatectomy were followed up regularly,176 patients with endocrine therapy and 148 with regular follow-up.Their ages range from 37-92 years old with an average of 70.9 years old.The PSA ranged from 1.04 to 1598.00 ng / ml with an average of 49.92 ng / ml.Clinical stage T: 45 cases of T1,147 cases of T2,54 cases of T3,47 cases of T4.123 cases had bone metastases and 170 cases had no bone metastases.GS?8 points is 135 cases,GS<8 points is 158 cases.The median PLR of PCa patients was 116.9(IQR,105.5-160.8).The median PLR of BPH patients was 111.0(IQR,93.9-132.6).The PLR of PCa group was slightly higher than BPH patients(P = 0.011).The median NLR of PCa patients was 2.33(IQR,1.7-3.0).The median NLR of BPH patients was 1.93(IQR,1.5-2.3).The NLR of PCa group was significantly higher than BPH patients(P = 0.008).The non-parametric analysis showed that the clinical stage,Gleason score and bone metastasis of PLR with PCa patients were correlated.The correlation between NLR and clinical T stage and bone metastasis(P <0.05),The area under the curve of PLR was 0.678(95% CI,0.638-0.718),and NLR was 0.682(95% CI,0.641-0.723),both of which had diagnostic value.The ROC curve was used to calculate the best cut-off values of PLRand NLR.It based on NLR> 2.46 and PLR> 165.3 for the screening of PCa patients in patients with PCa and BPH.For the surgical group,the ROC curve was used as the basis for calculating the best cut-off values of NLR and PLR.The cut-off values were set at 2.49 and 141.1,respectively.The NLR and PLR were divided into high-risk group and low-risk group.The high-risk group had biochemical recurrence free survival and overall survival was significantly longer than the low-risk group,and the clinical indicators Cox univariate and multivariate analysis showed that NLR?2.49,PLR?141.1 and clinical T stage?3 are the independent risk factors of PCa patients to biochemical recurrence.For the endocrine therapy group,according to the ROC curve,the optimal cut-off value of PLR and NLR calculated by the Youden index were 140.5 and 2.67,respectively.Similarly,PLR and NLR were divided into high-risk group and low-risk group.Compared with patients in low-risk group,patients in high-risk group had longer castration resistant progression free survival and overall survival,and NLR and PLR could be used as independent risk factors of PCa patients to early castration resistance.Conclusion:NLR and PLR can be used as one diagnostic criteria for screening PCa in patients with PCa and BPH,and PLR and NLR can be used to predict the prognosis of patients with PCa after RP and endocrine therapy.In addition,preoperative NLR and PLR may have something to do with the pathological stage,bone metastasis of PCa patients after RP,preoperative high NLR,PLR and clinical T staging?4 serve as the independent risk factors of PCa patients to biochemical recurrence;high NLR?PLR and GS?8 before endocrine therapy in patients with prostate cancer are independent risk factors of PCa patients to early castration resistance.To sum up,high PLR and NLR can be worked as clinical biochemical markers in addition to PSA to improve the diagnostic sensitivity of patients with prostate cancer and predict its prognosis. |
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