The Value Of Neutrophil-to-Lymphocyte Ratio In The Diagnosis Of Prostate Cancer

ObjectiveSerum prostate-specifc antigen has long been used as the preoperative evaluation indicator of prostate puncture for many years,and has been recommended as the first choice for diagnosis and treatment of prostate cancer due to its good diagnostic performance.However,PSA levels of patients with benign prostate diseases such as prostatic hyperplasia,acute and chronic prostatitis or trauma will also increase to varying degrees,and excessive puncture will often occur in clinical practice.Although transrectal ultrasound-guided prostate biopsy,as the gold standard.has the decisive diagnostic effect,the preoperative evaluation after the specificity reduction will inevitably lead to the decline in the efficiency of puncture biopsy diagnosis and treatment,or even the diagnosis and treatment failure.Therefore,we need to further improve the screening and detection program for prostate cancer in clinical work..In view of the urgent need in clinical work,the latest research and progress in the corresponding field in recent years are also frequently reported,such as SelectMDx,prostate cancer antigen3(PCA3),temprss2-erg,circulating tumor cell(CTC),Prostate Health Index(PHI),4-kallikrein score(4Kscore).However,the convenience,availability and cost of these tests have limited their clinical use,particularly in developing countries.We need to seek new biomarkers for prostate cancer,which can not only be economically and conveniently applied in clinical practice,but also effectively ensure the accuracy of prostate cancer screening.Therefore,neutrophil-to-lymphocyte ratio(NLR)was introduced into the study.In this study,by reviewing the preoperative NLR of prostate cancer and prostate hyperplasia patients before biopsy,the diagnostic effect of NLR on prostate cancer was discussed,so as to enrich the diagnostic program of prostate cancer.Material and methodsAll the cases in the study were from qilu hospital of shandong university,and all were hospitalized patients who underwent transrectal ultrasound-guided prostate biopsy from January 2014 to December 2016.All patients were divided into prostate cancer group and prostate hyperplasia group according to postoperative pathological results.By collecting the preoperative medical record information of each patient,we conducted a retrospective study on the preoperative blood indexes and postoperative pathological grading of each patient.Independent sample t test was conducted on preoperative information of all patients to analyze the difference indicators in the two groups of cases.Logistic analysis was improved to evaluate the risk factors of prostate cancer.In the study on the diagnostic value of NLR in prostate cancer,the ROC curve calculated its sensitivity and specificity as a monitoring indicator of prostate cancer.The correlation between NLR and postoperative pathological grading was discussed in combination with postoperative pathological grading of patients.Finally,the diagnostic efficacy of NLR in prostate cancer was studied in patients with PSA between 4 and 20 ng/ml.ResultsIn the univariate analysis study,we conducted t tests on neutrophil,age,total prostate-specifc antigen(TPSA),free prostate-specifc antigen(fPSA),albumin,lymphocyte,monocyte,NLR and neutrophil-to-monocyte ratio(NMR)of patients in the two groups.Indicators with significant differences included age(P<0.001),TPSA(P<0.001),FPSA(P<0.001),lymphocyte(P=0.004),and NLR(P=0.003).The results of logistics regression analysis of both univariate and multivariate studies showed that age,TPSA and NLR could be used as independent risk predictors in the diagnosis of prostate cancer.After calculating the area under the ROC curve,the relevant areas of age(0.675),TPSA(0.782)and NLR(0.71)reached the target value with predictive value,and the diagnostic specificity of NLR for prostate cancer was as high as 86.81%.There was a statistically significant difference in the value of NLR in different Gleason score groups(?6,=7,?8)(p=0.002),and there was a positive correlation between the two.In the data analysis of patients with fixed PSA interval(PSA 4?20 ng/ml),the difference in NLR level between the two groups within this interval was still significant(p<0.01),and the NLR level had predictive effect on prostate cancer in this interval(area under ROC curve 0.675).ConclusionsThe NLR of prostate cancer prior to prostate biopsy was higher than that of benign prostatic hyperplasia,and NLR was an independent predictor of prostate cancer.The Gleason grade of prostate cancer patients was associated with NLR,and high NLR level corresponded to high Gleason grade after surgery.