Neutrophil-lymphocyte ratio as an indicator of prostate cancer in biopsy tests

Shatylko T.V., Popkov V.M., Korolev A.Yu., Fomkin R.N., Polozov A.B.

Neutrophil-lymphocyte ratio (NLR) is a simple marker of a system inflammatory response, which can act as an independent prognostic factor for several solid malignant tumors, such as prostate cancer, whose diagnostics is an urgent problem of modern urology.

Materials and methods. In our study, we evaluated the role of NLR in male patients, who have undergone prostate biopsy aimed at primary diagnostics of prostate cancer. We have examined the data obtained from complete blood count and assays for prostate-specific antigen (PSA) and its free fraction in 1075 male patients. In 236 patients, the level of PSA was in the “gray zone” (4.0-10.0 ng/ml). They were subjected to transrectal biopsy. The analysis was performed using Mann-Whitney U test and chi-square test.

Results. NLR was found to be significantly higher in those men, whose PSA level more than 20 ng/ml, in comparison to other patients (p<0.001). NLR was also significantly higher in biopsy-positive patients. We have determined the threshold value for NLR (2.5) using ROC analysis. Its individual positive and negative predictive values constituted 54.9% and 62,3%, respectively. NLR has demonstrated good predictive capacity in a combination with the ratio of free and total PSA (whose threshold value was 0.15): its positive and negative predictive values were 75.5% and 62.3%, respectively. The individual prognostic function of NLR for prostate cancer diagnostics was confirmed by multivariate analysis. According to the data obtained, NLR can serve as a new biomarker for prostate cancer diagnostics in men, who need to undergo prostate biopsy. Further studies are necessary in order to evaluate the role of NLR as a prospective marker of the severity of prostate cancer and as a predictor of the effectiveness of treatment.

Authors declare lack of the possible conflicts of interests.

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biomarker, neutrophilic-lymphocyte index, prostate-specific antigen, prostate cancer, transrectal biopsy of the prostate