Abstract
To predict prostatic carcinoma using a logistic regression model on prebiopsy peripheral blood samples. Data of a total of 873 patients who consulted Urology Outpatient Clinics of Fatih Sultan Mehmet Training and Research Hospital between February 2008 and April 2014 scheduled for prostate biopsy were screened retrospectively. PSA levels, prostate volumes, prebiopsy whole blood cell counts, neutrophil and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), biopsy results and Gleason scores in patients who had established diagnosis of prostate cancer (PCa) were evaluated. This study was performed on a total of 873 cases, with an age range 48-76 years, divided into three groups as for biopsy results. with diagnoses of benign prostatic hyperplasia (BPH) (n=304, 34.8 %), PCa (n=265, 30.4%) and histological prostatitis (n=304; 34.8%). Intra- and intergroup comparative evaluations were performed. White blood cell and neutrophil counts in the histological prostatitis group were significantly higher than those of the BPH and PCa groups (p=0.001; p=0.004; p<0.01). A statistically significant intergroup difference was found for PLR (p=0.041; p<0.05) but not lymphocyte count (p>0.05). According to pairwise comparisons, PLR were significantly higher in the PCa group relative to BPH group (p=0.018, p<0.05, respectively). Though not statistically significant, higher PLR in cases with PCa in comparison with the prostatitis group was remarkable (p=0.067, and p>0.05, respectively). Meta-analyses showed that in patients with PSA levels over 4 ng/ml, positive predictive value of PSA is only 25 percent. Therefore, novel markers which can both detect clinically significant prostate cancer, and also prevent unnecessary biopsies are needed. Relevant to this issue in addition to PSA density, velocity, and PCA3, various markers have been analyzed. In the present study, PLR were found to be the additional predictor of prostatic carcinoma.
Highlights
Changes in host inflammatory responses and tumor relations have been increasingly recognized in various tumor types and inflammatory cells around the tumor cells play a significant role in the progress and prognosis of tumors
White blood cell (WBC) and Neutrophil counts were significantly higher in the histological prostatitis group when compared with benign prostatic hyperplasia (BPH) and prostate cancer (PCa) groups (p=0.001, p=0.004 and p
This study demonstrated that higher serum PSA levels were correlated with especially fibrinogen and neutrophil-to-lymphocyte ratio (NLR) (McDonald et al, 2014)
Summary
Changes in host inflammatory responses and tumor relations have been increasingly recognized in various tumor types and inflammatory cells around the tumor cells play a significant role in the progress and prognosis of tumors. The relationship between systemic inflammation markers and the outcome retains its complexity Among these markers, increased neutrophil-to-lymphocyte ratio (NLR) may be associated with neutrophil dependent systemic inflammatory response and lower lymphocyte levels with decreased antitumoral immune response which all may correlate with poor prognosis related to aggressive tumour biology and progression of cancer. Still some studies have indicated that thrombocytosis is associated with tumour load, while some others have demonstrated that platelets may play a role in tumour burden (Kerpsack and Finan, 2000). Thrombospondin is an adhesive glucoprotein which may increase adhesion of tumoral cells (Gungor et al, 2009). Though these factors seem to explain the association between platelets and cancerogenesis, lack of satisfactory information still exists
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