Monosit-lenfosit oranı, prostat kanserinin başka bir göstergesi olabilir mi?

Year 2023, Volume: 3 Issue: 1, 16 - 24, 27.04.2023

Gökçe Dündar Anıl Erkan

https://doi.org/10.58961/hmj.1202211

Abstract

Amaç: PSA'nın nispeten düşük duyarlılığı ve özgüllüğü nedeniyle tanı verimliliğini artırmak için ucuz, invaziv olmayan ve özellikle klinik önemli prostat kanserini tanıyabilen belirteçlere ihtiyaç vardır. MLR’nin prostat kanserinin bir biyobelirteci olarak potansiyel rolü olup olmadığının değerlendirilmesi amaçlanmıştır.
Çalışma planı: 1 Ocak 2017 ile 31 Aralık 2021 tarihleri arasında prostat biyopsisi alınan hastaların yaşı, işlem öncesinde lenfosit, monosit sayısı gibi hemogram parametreleri, free-total PSA değerleri, patoloji sonuçları kayıt altına alındı. Patoloji sonucu prostat kanseri (PCa) gelenlerin, Gleason Skoru 3+4 ve üzeri olan hastalar klinik anlamlı prostat kanseri (csPCa) olarak tanımlanırken, diğer PCa’li hastalar klinik anlamlı olmayan prostat kanseri (non-csPCa) olarak tanımlandı.
Bulgular: Çalışmaya dahil edilen 510 hastanın 164’ünün patolojisi PCa, 346’sının sonucu non-PCa olarak raporlandı. Monosit sayıları PCa’li grupta non-PCa gruptan daha yüksek bulundu. (sırasıyla; 0,61±0,33 ve 0,53±0,19, p=0.002) MLR de PCa grubunda daha yüksek bulundu. (sırasıyla; 0.35±0.29 ve 0.26±0.13, p<0.001) Tanı anındaki yaş, total PSA, monosit sayısı, MLR, PCa grubunda istatistiksel anlamlı olarak daha yüksek bulunurken, free/total PSA oranı (f/tPSA) bu grupta istatistiksel anlamlı daha düşük izlendi. Patolojisi PCa olarak raporlanan 164 hastalardan 69’unda (39%) csPCa bulunurken, 95’inde (61%) non-csPCa mevcuttu. Bu sub-grupların analizi yapıldığında tanı anındaki yaş, free PSA, total PSA csPCa grubunda istatistiksel anlamlı olarak daha yüksek bulunurken bu grupta f/tPSA değeri istatistiksel olarak anlamlı daha düşük bulundu. Lenfosit, monosit, MLR değerleri açısından csPCa ve non-csPCa grupları arasında istatistiksel olarak anlamlı bir fark bulunamadı.
Sonuç: Biyopsi yapılan hastalarda 0.3’ün üzerindeki MLR değeri olması halinde patolojinin PCa olarak sonuçlanması %27,4 duyarlılık ve %85,3 özgüllük ile öngörülebilir.

Keywords

monosit-lenfosit oranı, monosit, prostat kanseri, prostat biyopsisi

Project Number

Yok

Can the monocyte-to-lymphocyte ratio be another predictor of prostate cancer?

Abstract

Introduction: This study aimed to evaluate whether monocyte-lymphocyte-ratio (MLR) had a potential role as a biomarker of prostate cancer (PCa).
Methods: For patients who underwent a prostate biopsy between January 1, 2017, and December 31, 2021, age, hemogram parameters, free-total PSA values, and pathology results were recorded. Patients with a pathology result of PCa and those with a Gleason score of 3+4 and above were defined as having clinically significant PCa (csPCa), while other PCa cases were defined as having clinically non-significant PCa (non-csPCa).
Results: The pathology result was reported as PCa in 164 of the 510 patients included in the study and non-PCa in 346. The monocyte count was found to be higher in the PCa group than in the non-PCa group (0.61±0.33 and 0.53±0.19, respectively; p=0.002). MLR was also significantly higher in the PCa group (0.35±0.29 and 0.26±0.13, respectively; p<0.001). Of 164 patients whose pathology was reported as PCa, 69 (39%) had csPCa and 95 (61%) had non-csPCa. When these PCa subgroups were analyzed, age at diagnosis, free PSA, and total PSA were found to be statistically significantly higher in the csPCa group, while the f/tPSA value was statistically significantly lower in this group. There was no statistically significant difference between the csPCa and non-csPCa groups in terms of the lymphocyte and monocyte counts, and MLR.
Conclusions: In patients undergoing a biopsy, an MLR value above 0.3 can predict the pathology result being reported as PCa at a sensitivity of 27.4% and specificity of 85.3%.

Keywords

monocyte-to-lymphocyte ratio, monocyte, prostate cancer, prostate biopsy

Supporting Institution

Yok

Project Number

Yok

Thanks

We are grateful to Prof. Guven Ozkaya for his contribution to the statistical analysis. We also thank our colleagues who performed transrectal ultrasound-guided prostate biopsies. The first author also thanks Prof. Dr. Gökhan Gökçe and Prof. Dr. Murat Demirbaş for their academic guidance.

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