Wang H, et al. – In this study, researchers planned to validate the clinical usefulness of neutrophil-lymphocyte ratio (NLR) in discriminating real GS ≥ 7 prostate cancer (PCa) from biopsy-based GS ≤ 6 PCa in comparison with serum total prostate-specific antigen (tPSA) and value of their combination. Results revealed significantly elevated serum tPSA and NLR among GS ≥ 7 PCa concurrently. On discriminating real GS ≥ 7 Pca from biopsy-based GS ≤ 6 PCa, the combination of tPSA and NLR seemed to have additional benefit to biopsy

Methods

• This study incorporated one hundred one patients who underwent physical examinations incidentally found elevated tPSA and subsequently received biopsy with a conclusion of GS ≤ 6 and RP with an interval of 4-6 weeks after biopsy.
• They acquired NLR and tPSA within 15 days prior to biopsy.
• They applied logistic regression model appropriately.
• In order to evaluate differences among tPSA, NLR and their combination and corresponding diagnostic power, McNemar tests and AUC model were performed.

Results

• 61 patients with GS ≤ 6 and 100 patients with GS ≥ 7 were comprised in the pathological results from RP specimen.
• An association was observed between higher tPSA and NLR and patients with actual GS ≥ 7.
• In addition, tPSA (OR = 1.088, 95% C.I. = 1.029-1.151, P = 0.003) and NLR (OR =1.807, 95% C.I. = 1.021-3.200, P = 0.042) were suggested as independent predictors for GS groupings.
• Moreover, under cutoff value of 14.09 ng/ml for tPSA and 2.25 for NLR, the sensitivity, specificity and accuracy were 60.0%, 80.3% and 67.7% for tPSA, 42%, 88.5% and 59.6% for NLR, and 71.0%, 75.4% and 72.7% for combination of tPSA and NLR (tPSA + NLR) respectively.
• As compared to tPSA and NLR, the sensitivity of tPSA + NLR was significantly higher.
• There was no significant difference between tPSA and NLR in specificity (P = 0.227) and accuracy (P = 0.132), except for sensitivity.
• Furthermore, tPSA got the largest AUC with 0.732 (p < 0.001, 95% C.I.: 0.651-0.813).