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

Year 2024, , 29 - 32, 30.04.2024

Ali Kaan Yıldız , Turgay Kaçan , Aykut Koç , Berat Cem Özgür

https://doi.org/10.20492/aeahtd.1311308

Abstract

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.

Keywords

prostat, kanser, biyopsi, nötrofil, lenfosit.

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

Abstract

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.

Keywords

prostate, cancer, biopsy, neutrophil, lymphocyte.

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