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Prostat kanserinin tanısında beyaz küre, nötrofil, lenfosit ve trombosit sayılarının birbirine oranlarının prediktif rolü

Yıl 2024, Cilt: 57 Sayı: 1, 29 - 32, 30.04.2024
https://doi.org/10.20492/aeahtd.1311308

Öz

Amaç: Çalışma prostat spesifik antijeni (PSA) değerleri 4,0–20,0 ng/mL olan ve transrektal prostat biyopsisi yapılan hastalarda, prostat kanseri saptanmasında prediktif olabilecek hematolojik kriterleri araştırmayı hedeflemektedir.
Gereç ve Yöntem: Ocak 2022 ile Aralık 2022 tarihleri arasında PSA değerleri 4,0–20,0 ng/mL olan, transrektal prostat biyopsisi yapılan hastaların biyopsi sonuçlarına göre retrospektif analiz yapıldı. Çalışmaya biyopsi sonucu prostat kanseri (26) ve benign prostat dokusu (41) tanısı alan, iki grupta toplam 67 hasta dahil edildi. Prostat kanserini predikte edebilecek toplam beyaz küre (WBC), nötrofil, lenfosit, trombosit sayısı ve birbirine oranları tek ve çok değişkenli analizler ile incelendi. Ayrıca eğri altında kalan alanı hesaplamak ve parametrelerin tanısal performansını değerlendirmek için ROC eğrileri üretildi ve en iyi limit değeri belirlendi.
Bulgular: WBC/nötrofil ve trombosit/nötrofil oranı prostat kanseri grubunda anlamlı yüksek (sırasıyla p=0.004 ve p=0.001), nötrofil/lenfosit oranı prostat kanseri grubunda anlamlı düşük olarak saptandı (p=0.048). Anlamlı fark bulunan bu faktörler ile yapılan çok değişkenli lojistik regresyon analizinde, WBC/nötrofil (odds ratio [OR] 0.00, %95 GA: 0.00–0.29; p = 0.001), nötrofil/lenfosit (OR 0.12, %95 GA: 0.03-0.48; p = 0.003) ve trombosit/nötrofil (OR 0.94, %95 GA: 0.89-0.98; p = 0.013) prostat kanseri ile ilişkiliydi. ROC analizinde WBC/nötrofil için AUC 0.712 (%95 CI 0.582-0.843) bulundu. En iyi limit değeri 1.69 olarak belirlendi ve ≥ 1.69 olan değerler için sensivite 0.69, spesifite 0.68 ve tanısal verimlilik 0.68 saptandı. ROC analizinde trombosit/nötrofil için AUC 0.705 (%95 CI 0.573-0.838) bulundu. En iyi limit değeri 58.4 olarak belirlendi ve ≥ 58.4 olan değerler için sensivite 0.69, spesifite 0.73 ve tanısal verimlilik 0.71 saptandı.
Sonuç: PSA’sı 4,0–20,0 ng/mL olan hastalarda WBC/nötrofil ve trombosit/nötrofil oranlarının prostat biyopsisinde kanser saptanmasını öngörebilecek basit, klinikte rutin uygulanan ve başarılı parametreler olabileceği gösterilmiştir.

Kaynakça

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a cancer journal for clinicians. 2021; 71(3):209-49.
  • 2. Kimura T, Egawa S. Epidemiology of prostate cancer in Asian countries. International journal of urology : official journal of the Japanese Urological Association. 2018; 25(6):524-31.
  • 3. Srigley JR, Delahunt B, Samaratunga H, Billis A, Cheng L, Clouston D, et al. Controversial issues in Gleason and International Society of Urological Pathology (ISUP) prostate cancer grading: proposed recommendations for international implementation. Pathology. 2019; 51(5):463-73.
  • 4. Sfanos KS, Yegnasubramanian S, Nelson WG, De Marzo AM. The inflammatory microenvironment and microbiome in prostate cancer development. Nature reviews Urology. 2018; 15(1):11-24.
  • 5. Huszno J, Kołosza Z, Mrochem-Kwarciak J, Telka E, Jochymek B, Miszczyk L. Role of neutrophil-lymphocyte ratio, platelet- lymphocyte ratio, lymphocyte-monocyte ratio and platelets in prognosis of patients with prostate cancer. Oncology letters. 2022; 24(3):305.
  • 6. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008; 454(7203):436-44.
  • 7. Coussens LM, Zitvogel L, Palucka AK. Neutralizing tumor- promoting chronic inflammation: a magic bullet? Science (New York, NY). 2013; 339(6117):286-91.
  • 8. Engblom C, Pfirschke C, Pittet MJ. The role of myeloid cells in cancer therapies. Nature reviews Cancer. 2016; 16(7):447-62.
  • 9. Haemmerle M, Stone RL, Menter DG, Afshar-Kharghan V, Sood AK. The Platelet Lifeline to Cancer: Challenges and Opportunities. Cancer Cell. 2018; 33(6):965-83.
  • 10. Ray-Coquard I, Cropet C, Van Glabbeke M, Sebban C, Le Cesne A, Judson I, et al. Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas. Cancer research. 2009; 69(13):5383-91.
  • 11. Ceylan C, Doluoglu OG, Keleş I, Gazel E, Temuçin T, Odabaş Ö, et al. Importance of the neutrophil-to-lymphocyte ratio in muscle-invasive and non-muscle invasive bladder tumors. Urologia. 2014; 81(2):120-4.
  • 12. Başer A. Does the Decrease in Neutrophil-lymphocyte Ratio after BCG Treatment Be a Prognostic Marker for NMIBC? Journal of Urological Surgery. 2020; 7(4):271-5.
  • 13. Deniz ME, Erçil H, Alma E, Tümer E, Ünal U, Altunkol A, et al. The Role Of Blood Neutrophil / Lymphocyte Distribution in The Diagnosis Of Prostate Cancer. The New Journal of Urology. 2020; 15(2):66-74.
  • 14. Zanaty M, Ajib K, Alnazari M, El Rassy E, Aoun F, Zorn KC, et al. Prognostic utility of neutrophil-to-lymphocyte and platelets- to-lymphocyte ratio in predicting biochemical recurrence post robotic prostatectomy. Biomarkers in medicine. 2018; 12(8):841-8.
  • 15. Ipekçi T, Yüksel M, Uçar M, Tunçkıran M, Kozacioglu Z, Akman RY. Is Preoperative Neutrophil Lymphocyte Ratio a Reliable Prognostic Parameter for Localized Prostate Cancer? Üroonkoloji Bülteni. 2017; 16:1-4.
  • 16. Çelen S, Özlülerden Y. Düşük risk prostat kanserinde nötrofil lenfosit oranı veya platelet lenfosit oranı tümörde evre yükselmesini öngörebilir mi ? Pamukkale Medical Journal. 2021; 14(1):119-24.
  • 17. Adhyatma KP, Warli SM. Diagnostic Value of Platelet- To-Lymphocyte Ratio in Prostate Cancer. Open access Macedonian journal of medical sciences. 2019; 7(7):1093-6.
  • 18. Lee JW, Jeong H, Son H, Cho MC. Platelet-to-lymphocyte ratio is not a predictor of clinically significant prostate cancer at the prostate biopsy: A large cohort study. Scientific Reports. 2021; 11(1):14240.
  • 19. Murray NP, Fuentealba C, Salazar A, Reyes E. Platelet- to-lymphocyte ratio and systemic immune-inflammation index versus circulating prostate cells to predict significant prostate cancer at first biopsy. Turkish journal of urology. 2020; 46(2):115-22.
  • 20. Abuzallouf S, Dayes I, Lukka H. Baseline staging of newly diagnosed prostate cancer: a summary of the literature. The Journal of urology. 2004; 171(6 Pt 1):2122-7.
  • 21. Ma R-Y, Zhang H, Li X-F, Zhang C-B, Selli C, Tagliavini G, et al. Monocyte-derived macrophages promote breast cancer bone metastasis outgrowth. Journal of Experimental Medicine. 2020; 217(11)
  • 22. Pittet MJ, Michielin O, Migliorini D. Clinical relevance of tumour- associated macrophages. Nature Reviews Clinical Oncology. 2022; 19(6):402-21.
  • 23. Kwiecień I, Rutkowska E, Polubiec-Kownacka M, Raniszewska A, Rzepecki P, Domagała-Kulawik J. Blood Monocyte Subsets with Activation Markers in Relation with Macrophages in Non-Small Cell Lung Cancer. Cancers. 2020; 12(9):2513.
  • 24. Kikuchi E, Nakashima J, Ishibashi M, Ohigashi T, Asakura H, Tachibana M, et al. Prostate specific antigen adjusted for transition zone volume: the most powerful method for detecting prostate carcinoma. Cancer. 2000; 89(4):842-9.
  • 25. Başer A, Aydın C, Çelikörs B, Yılmaz Başer H, Baykam MM, Alkış O. PSA seviyesi 4-10 ng/mL olan hastalarda alt üriner sistem semptomları patoloji sonucunu ön görebilir mi? Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2020; 53(2):81-4.

Predictive Value of Ratios of White Blood Cell, Neutrophil, Lymphocyte, and Platelet Counts in the Diagnosis of Prostate Cancer

Yıl 2024, Cilt: 57 Sayı: 1, 29 - 32, 30.04.2024
https://doi.org/10.20492/aeahtd.1311308

Öz

Objective: To investigate the hematological criteria that can predict prostate cancer detection in patients with values of prostate specific antigen (PSA) of 4.0 to 20.0 ng / ml and undergoing transrectal prostate biopsy.
Materials and Methods: Retrospective analysis was performed according to biopsy results of patients who underwent transrectal prostate biopsy between January 2022 and December 2022 with PSA values of 4.0 to 20.0 ng / mL. A total of 67 patients in two groups, diagnosed with prostate cancer (26) and benign prostate tissue (41) as a result of biopsy, were included in the study. Total white blood cell (WBC), neutrophil, lymphocyte, platelet count, and their ratios that could predict prostate cancer were analysed using univariate and multivariate analyses. Additionally, ROC curves were generated to calculate the area under the curve and to evaluate the diagnostic performance of the parameters, and the best limit value was determined.
Results: The WBC/neutrophil and platelet/neutrophil ratios were significantly higher in the prostate cancer group (p=0.004 and p=0.001, respectively), while the neutrophil/lymphocyte ratio was significantly lower in the prostate cancer group (p=0.048). In multivariate logistic regression analysis with these significantly different factors, WBC/neutrophil (odds ratio [OR] 0.00, 95% CI: 0.00–0.29; p = 0.001), neutrophil/lymphocyte (OR 0.12, 95% CI: 0.03- 0.48; p = 0.003) and platelet/neutrophil (OR 0.94, 95% CI: 0.89-0.98; p = 0.013) were associated with prostate cancer. The AUC for WBC/neutrophil in the ROC analysis was 0.712 (95% CI 0.582-0.843) and for platelet/neutrophil was 0.705 (95% CI 0.573-0.838). The best cut-off value was determined as 1.69 for WBC/neutrophil and as 58.4 for platelet/neutrophil.
Conclusion: WBC/neutrophil and platelet/neutrophil ratios have been shown to be simple, routinely applied, and successful parameters that can predict cancer detection on prostate biopsy in patients with PSA 4.0 to 20.0 ng / ml.

Kaynakça

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a cancer journal for clinicians. 2021; 71(3):209-49.
  • 2. Kimura T, Egawa S. Epidemiology of prostate cancer in Asian countries. International journal of urology : official journal of the Japanese Urological Association. 2018; 25(6):524-31.
  • 3. Srigley JR, Delahunt B, Samaratunga H, Billis A, Cheng L, Clouston D, et al. Controversial issues in Gleason and International Society of Urological Pathology (ISUP) prostate cancer grading: proposed recommendations for international implementation. Pathology. 2019; 51(5):463-73.
  • 4. Sfanos KS, Yegnasubramanian S, Nelson WG, De Marzo AM. The inflammatory microenvironment and microbiome in prostate cancer development. Nature reviews Urology. 2018; 15(1):11-24.
  • 5. Huszno J, Kołosza Z, Mrochem-Kwarciak J, Telka E, Jochymek B, Miszczyk L. Role of neutrophil-lymphocyte ratio, platelet- lymphocyte ratio, lymphocyte-monocyte ratio and platelets in prognosis of patients with prostate cancer. Oncology letters. 2022; 24(3):305.
  • 6. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008; 454(7203):436-44.
  • 7. Coussens LM, Zitvogel L, Palucka AK. Neutralizing tumor- promoting chronic inflammation: a magic bullet? Science (New York, NY). 2013; 339(6117):286-91.
  • 8. Engblom C, Pfirschke C, Pittet MJ. The role of myeloid cells in cancer therapies. Nature reviews Cancer. 2016; 16(7):447-62.
  • 9. Haemmerle M, Stone RL, Menter DG, Afshar-Kharghan V, Sood AK. The Platelet Lifeline to Cancer: Challenges and Opportunities. Cancer Cell. 2018; 33(6):965-83.
  • 10. Ray-Coquard I, Cropet C, Van Glabbeke M, Sebban C, Le Cesne A, Judson I, et al. Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas. Cancer research. 2009; 69(13):5383-91.
  • 11. Ceylan C, Doluoglu OG, Keleş I, Gazel E, Temuçin T, Odabaş Ö, et al. Importance of the neutrophil-to-lymphocyte ratio in muscle-invasive and non-muscle invasive bladder tumors. Urologia. 2014; 81(2):120-4.
  • 12. Başer A. Does the Decrease in Neutrophil-lymphocyte Ratio after BCG Treatment Be a Prognostic Marker for NMIBC? Journal of Urological Surgery. 2020; 7(4):271-5.
  • 13. Deniz ME, Erçil H, Alma E, Tümer E, Ünal U, Altunkol A, et al. The Role Of Blood Neutrophil / Lymphocyte Distribution in The Diagnosis Of Prostate Cancer. The New Journal of Urology. 2020; 15(2):66-74.
  • 14. Zanaty M, Ajib K, Alnazari M, El Rassy E, Aoun F, Zorn KC, et al. Prognostic utility of neutrophil-to-lymphocyte and platelets- to-lymphocyte ratio in predicting biochemical recurrence post robotic prostatectomy. Biomarkers in medicine. 2018; 12(8):841-8.
  • 15. Ipekçi T, Yüksel M, Uçar M, Tunçkıran M, Kozacioglu Z, Akman RY. Is Preoperative Neutrophil Lymphocyte Ratio a Reliable Prognostic Parameter for Localized Prostate Cancer? Üroonkoloji Bülteni. 2017; 16:1-4.
  • 16. Çelen S, Özlülerden Y. Düşük risk prostat kanserinde nötrofil lenfosit oranı veya platelet lenfosit oranı tümörde evre yükselmesini öngörebilir mi ? Pamukkale Medical Journal. 2021; 14(1):119-24.
  • 17. Adhyatma KP, Warli SM. Diagnostic Value of Platelet- To-Lymphocyte Ratio in Prostate Cancer. Open access Macedonian journal of medical sciences. 2019; 7(7):1093-6.
  • 18. Lee JW, Jeong H, Son H, Cho MC. Platelet-to-lymphocyte ratio is not a predictor of clinically significant prostate cancer at the prostate biopsy: A large cohort study. Scientific Reports. 2021; 11(1):14240.
  • 19. Murray NP, Fuentealba C, Salazar A, Reyes E. Platelet- to-lymphocyte ratio and systemic immune-inflammation index versus circulating prostate cells to predict significant prostate cancer at first biopsy. Turkish journal of urology. 2020; 46(2):115-22.
  • 20. Abuzallouf S, Dayes I, Lukka H. Baseline staging of newly diagnosed prostate cancer: a summary of the literature. The Journal of urology. 2004; 171(6 Pt 1):2122-7.
  • 21. Ma R-Y, Zhang H, Li X-F, Zhang C-B, Selli C, Tagliavini G, et al. Monocyte-derived macrophages promote breast cancer bone metastasis outgrowth. Journal of Experimental Medicine. 2020; 217(11)
  • 22. Pittet MJ, Michielin O, Migliorini D. Clinical relevance of tumour- associated macrophages. Nature Reviews Clinical Oncology. 2022; 19(6):402-21.
  • 23. Kwiecień I, Rutkowska E, Polubiec-Kownacka M, Raniszewska A, Rzepecki P, Domagała-Kulawik J. Blood Monocyte Subsets with Activation Markers in Relation with Macrophages in Non-Small Cell Lung Cancer. Cancers. 2020; 12(9):2513.
  • 24. Kikuchi E, Nakashima J, Ishibashi M, Ohigashi T, Asakura H, Tachibana M, et al. Prostate specific antigen adjusted for transition zone volume: the most powerful method for detecting prostate carcinoma. Cancer. 2000; 89(4):842-9.
  • 25. Başer A, Aydın C, Çelikörs B, Yılmaz Başer H, Baykam MM, Alkış O. PSA seviyesi 4-10 ng/mL olan hastalarda alt üriner sistem semptomları patoloji sonucunu ön görebilir mi? Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2020; 53(2):81-4.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Üroloji
Bölüm Araştırma Makalesi
Yazarlar

Ali Kaan Yıldız 0000-0002-0999-9872

Turgay Kaçan 0000-0002-7211-8433

Aykut Koç 0000-0002-9130-7301

Berat Cem Özgür 0000-0003-1480-8441

Yayımlanma Tarihi 30 Nisan 2024
Gönderilme Tarihi 7 Haziran 2023
Yayımlandığı Sayı Yıl 2024 Cilt: 57 Sayı: 1

Kaynak Göster

AMA Yıldız AK, Kaçan T, Koç A, Özgür BC. Prostat kanserinin tanısında beyaz küre, nötrofil, lenfosit ve trombosit sayılarının birbirine oranlarının prediktif rolü. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. Nisan 2024;57(1):29-32. doi:10.20492/aeahtd.1311308