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Prostat biyopsisinde prostat kanserini öngörmede inflamatuar bir belirteç: monosit-lenfosit oranı

Year 2021, Volume: 16 Issue: 2, 101 - 109, 29.06.2021
https://doi.org/10.33719/yud.2021;16-2-794684

Abstract

Amaç: Prostat kanseri (PCa) tanısında inflamatuvar parametrelerin, özellikle monosit-lenfosit oranının (MLR) prediktif rolünü değerlendirmek amaçlandı.

Gereç ve Yöntemler: Temmuz 2015 ile Temmuz 2019 arasında prostat biyopsisi yapılan hastaların verileri retrospektif olarak analiz edildi.Yaş, PSA, nötrofil-lenfosit oranı (NLR), platelet-lenfosit oranı (PLR), MLR ve histopatolojileri içeren veriler kaydedildi. Hastalar prostat biyopsi histopatolojisine göre benign prostat hiperplazisi (BPH), PCa ve prostatit olarak gruplandırıldı ve tüm değişkenler incelendi.

Bulgular: 338 hastanın 124 (%36.7)'ü BPH, 132 (%39.1)'si PCa ve 82 (%24.3)'sinde prostatit patolojisi mevcuttu. PCa'lı hastalar daha yaşlıydı ve PCa olmayan hastalara kıyasla daha yüksek serum PSA, PLR, NLR ve MLR değerlerine sahipti. Metastatik hastalar dışlanarak yapılan karşılaştırmada sadece serum PSA ve MLR değerleri istatistiksel olarak yüksek kaldı. Tüm kohortta her üç parametre PCa'yı tahmin etmede anlamlı AUC'ye sahipken, metastatik hastaların çıkarıldığı kohortta yalnızca MLR PCa'yı tahmin etmede anlamlı AUC'ye sahipti. Çok değişkenli lojistik regresyon analizinde, sadece serum PSA ve MLR'nin PCa'nın anlamlı bağımsız prediktörleri olduğunu görüldü.

Sonuç: PCa hastalarında tüm enflamatuar belirteçler yüksekti, ancak sadece MLR metastatik PCa hastaları çıkarıldıktan sonra da yüksek kaldı. Çok değişkenli modelde PSA ve yaş ile MLR kombinasyonu, PCa'nın anlamlı bağımsız prediktörüdür.

References

  • 1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018;68(6):394-424.
  • 2. Cuzick J, Thorat MA, Andriole G, et al. Prevention and early detection of prostate cancer. The Lancet Oncology. 2014;15(11):e484-92.
  • 3. Thompson IM, Ankerst DP, Chi C, et al. Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial. Journal of the National Cancer Institute. 2006;98(8):529-34.
  • 4. Salman JW, Schoots IG, Carlsson SV, Jenster G, Roobol MJ. Prostate Specific Antigen as a Tumor Marker in Prostate Cancer: Biochemical and Clinical Aspects. Advances in experimental medicine and biology. 2015;867:93-114.
  • 5. Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer-related inflammation and treatment effectiveness. The Lancet Oncology. 2014;15(11):e493-503.
  • 6. Kawahara T, Fukui S, Sakamaki K, et al. Neutrophil-to-lymphocyte ratio predicts prostatic carcinoma in men undergoing needle biopsy. Oncotarget. 2015;6(31):32169-76.
  • 7. Oh JJ, Kwon O, Lee JK, et al. Association of the neutrophil-to-lymphocyte ratio and prostate cancer detection rates in patients via contemporary multi-core prostate biopsy. Asian J Androl. 2016;18(6):937-41.
  • 8. Huang T-B, Mao S-Y, Lu S-M, et al. Predictive value of neutrophil-to-lymphocyte ratio in diagnosis of prostate cancer among men who underwent template-guided prostate biopsy: A STROBE-compliant study. Medicine (Baltimore). 2016;95(44):e5307-e.
  • 9. Adhyatma KP, Prapiska FF, Siregar GP, Warli SM. Systemic Inflammatory Response in Predicting Prostate Cancer: The Diagnostic Value of Neutrophil-To-Lymphocyte Ratio. Open Access Maced J Med Sci. 2019;7(10):1628-30.
  • 10. Yuksel OH, Urkmez A, Akan S, Yldirim C, Verit A. Predictive Value of the Platelet-To-Lymphocyte Ratio in Diagnosis of Prostate Cancer. Asian Pac J Cancer Prev. 2015;16(15):6407-12.
  • 11. Adhyatma KP, Warli SM. Diagnostic Value of Platelet-To-Lymphocyte Ratio in Prostate Cancer. Open Access Maced J Med Sci. 2019;7(7):1093-6.
  • 12. Hayashi T, Fujita K, Tanigawa G, et al. Serum monocyte fraction of white blood cells is increased in patients with high Gleason score prostate cancer. Oncotarget. 2017;8(21):35255-61.
  • 13. Caglayan V, Onen E, Avci S, et al. Lymphocyte-to-monocyte ratio is a valuable marker to predict prostate cancer in patients with prostate specific antigen between 4 and 10 ng/dl. Arch Ital Urol Androl. 2019;90(4):270-5.
  • 14. Stamey TA, Yang N, Hay AR, et al. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. The New England journal of medicine. 1987;317(15):909-16.
  • 15. Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. The New England journal of medicine. 2004;350(22):2239-46.
  • 16. Loeb S, Roehl KA, Antenor JA, et al. Baseline prostate-specific antigen compared with median prostate-specific antigen for age group as predictor of prostate cancer risk in men younger than 60 years old. Urology. 2006;67(2):316-20.
  • 17. Kundu SD, Roehl KA, Antenor JAV, Catalona WJ, Nadler RB. 953: Age-Specific Risk of Prostate Cancer if PSA is between the Median Value and Commonly Used Biopsy Thresholds. The Journal of Urology. 2005;173(4, Supplement):258.
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  • 19. Sutcliffe S, Platz EA. Inflammation in the etiology of prostate cancer: an epidemiologic perspective. Urologic oncology. 2007;25(3):242-9.
  • 20. Sciarra A, Mariotti G, Salciccia S, et al. Prostate growth and inflammation. The Journal of steroid biochemistry and molecular biology. 2008;108(3-5):254-60.
  • 21. Sfanos KS, De Marzo AM. Prostate cancer and inflammation: the evidence. Histopathology. 2012;60(1):199-215.
  • 22. Keizman D, Gottfried M, Ish-Shalom M, et al. Pretreatment neutrophil-to-lymphocyte ratio in metastatic castration-resistant prostate cancer patients treated with ketoconazole: association with outcome and predictive nomogram. Oncologist. 2012;17(12):1508-14.
  • 23. Gu X, Gao X, Li X, et al. Prognostic significance of neutrophil-to-lymphocyte ratio in prostate cancer: evidence from 16,266 patients. Scientific reports. 2016;6:22089.
  • 24. Wang J, Zhou X, He Y, et al. Prognostic role of platelet to lymphocyte ratio in prostate cancer: A meta-analysis. Medicine (Baltimore). 2018;97(40):e12504.
  • 25. Guo J, Fang J, Huang X, et al. Prognostic role of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in prostate cancer: A meta-analysis of results from multivariate analysis. International journal of surgery (London, England). 2018;60:216-23.
  • 26. Gokce MI, Hamidi N, Suer E, et al. Evaluation of neutrophil-to-lymphocyte ratio prior to prostate biopsy to predict biopsy histology: Results of 1836 patients. Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2015;9(11-12):E761-5.
  • 27. Kaynar M, Yildirim ME, Gul M, et al. Benign prostatic hyperplasia and prostate cancer differentiation via platelet to lymphocyte ratio. Cancer Biomarkers. 2015;15:317-23.
  • 28. Kamali K, Ashrafi M, Shadpour P, et al. The role of blood neutrophil count and the neutrophil-to-lymphocyte ratio as a predictive factor for prostate biopsy results. Urologia. 2018;85(4):158-62.
  • 29. Eren H. Predictive Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratio Measured Prior to Prostate Biopsy. Journal of Urological Surgery. 2020;7(1):37-41.

An inflammatory marker for predicting prostate cancer in prostate biopsy: monocyte-to-lymphocyte ratio

Year 2021, Volume: 16 Issue: 2, 101 - 109, 29.06.2021
https://doi.org/10.33719/yud.2021;16-2-794684

Abstract

Objective: To evaluate the predictive role of the inflammatory parameters, especially monocyte-to-lymphocyte (MLR) ratio, on the diagnosis of prostate cancer (PCa).

Meterial and Methods: The data of patients undergoing prostate biopsy between July 2015 and July 2019 were retrospectively analyzed. The data including age, PSA, neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), MLR and histopathologies were recorded. Patients were grouped as benign prostatic hyperplasia (BPH), PCa and prostatitis according to PBx histopathology and all variables were analyzed.

Results: Pathology results of 338 patients are as follows: 124 (36.7%) BPH, 132 (39.1%) PCa and 82 (24.3%) prostatitis. Patients with PCa were older and had higher serum PSA, PLR, NLR and MLR values compared to non-PCa patients. In the comparison made by excluding metastatic patients, only serum PSA and MLR values remained statistically high. All three parameters had significant AUC to predict PCa in entire-cohort, but only the MLR had significant AUC to predict PCa in the cohort which metastatic patients were excluded. Multivariate logistic regression analysis revealed that only serum PSA and MLR values were significant independent predictors of PCa.

Conclusion: All inflammatory markers were high in PCa patients, but, only MLR value remained high after metastatic PCa patients were excluded. MLR combination with PSA and age in the multivariate model is significant independent predictor of PCa.

References

  • 1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018;68(6):394-424.
  • 2. Cuzick J, Thorat MA, Andriole G, et al. Prevention and early detection of prostate cancer. The Lancet Oncology. 2014;15(11):e484-92.
  • 3. Thompson IM, Ankerst DP, Chi C, et al. Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial. Journal of the National Cancer Institute. 2006;98(8):529-34.
  • 4. Salman JW, Schoots IG, Carlsson SV, Jenster G, Roobol MJ. Prostate Specific Antigen as a Tumor Marker in Prostate Cancer: Biochemical and Clinical Aspects. Advances in experimental medicine and biology. 2015;867:93-114.
  • 5. Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer-related inflammation and treatment effectiveness. The Lancet Oncology. 2014;15(11):e493-503.
  • 6. Kawahara T, Fukui S, Sakamaki K, et al. Neutrophil-to-lymphocyte ratio predicts prostatic carcinoma in men undergoing needle biopsy. Oncotarget. 2015;6(31):32169-76.
  • 7. Oh JJ, Kwon O, Lee JK, et al. Association of the neutrophil-to-lymphocyte ratio and prostate cancer detection rates in patients via contemporary multi-core prostate biopsy. Asian J Androl. 2016;18(6):937-41.
  • 8. Huang T-B, Mao S-Y, Lu S-M, et al. Predictive value of neutrophil-to-lymphocyte ratio in diagnosis of prostate cancer among men who underwent template-guided prostate biopsy: A STROBE-compliant study. Medicine (Baltimore). 2016;95(44):e5307-e.
  • 9. Adhyatma KP, Prapiska FF, Siregar GP, Warli SM. Systemic Inflammatory Response in Predicting Prostate Cancer: The Diagnostic Value of Neutrophil-To-Lymphocyte Ratio. Open Access Maced J Med Sci. 2019;7(10):1628-30.
  • 10. Yuksel OH, Urkmez A, Akan S, Yldirim C, Verit A. Predictive Value of the Platelet-To-Lymphocyte Ratio in Diagnosis of Prostate Cancer. Asian Pac J Cancer Prev. 2015;16(15):6407-12.
  • 11. Adhyatma KP, Warli SM. Diagnostic Value of Platelet-To-Lymphocyte Ratio in Prostate Cancer. Open Access Maced J Med Sci. 2019;7(7):1093-6.
  • 12. Hayashi T, Fujita K, Tanigawa G, et al. Serum monocyte fraction of white blood cells is increased in patients with high Gleason score prostate cancer. Oncotarget. 2017;8(21):35255-61.
  • 13. Caglayan V, Onen E, Avci S, et al. Lymphocyte-to-monocyte ratio is a valuable marker to predict prostate cancer in patients with prostate specific antigen between 4 and 10 ng/dl. Arch Ital Urol Androl. 2019;90(4):270-5.
  • 14. Stamey TA, Yang N, Hay AR, et al. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. The New England journal of medicine. 1987;317(15):909-16.
  • 15. Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. The New England journal of medicine. 2004;350(22):2239-46.
  • 16. Loeb S, Roehl KA, Antenor JA, et al. Baseline prostate-specific antigen compared with median prostate-specific antigen for age group as predictor of prostate cancer risk in men younger than 60 years old. Urology. 2006;67(2):316-20.
  • 17. Kundu SD, Roehl KA, Antenor JAV, Catalona WJ, Nadler RB. 953: Age-Specific Risk of Prostate Cancer if PSA is between the Median Value and Commonly Used Biopsy Thresholds. The Journal of Urology. 2005;173(4, Supplement):258.
  • 18. Lippi G, Montagnana M, Guidi GC, Plebani M. Prostate-specific antigen-based screening for prostate cancer in the third millennium: useful or hype? Annals of medicine. 2009;41(7):480-9.
  • 19. Sutcliffe S, Platz EA. Inflammation in the etiology of prostate cancer: an epidemiologic perspective. Urologic oncology. 2007;25(3):242-9.
  • 20. Sciarra A, Mariotti G, Salciccia S, et al. Prostate growth and inflammation. The Journal of steroid biochemistry and molecular biology. 2008;108(3-5):254-60.
  • 21. Sfanos KS, De Marzo AM. Prostate cancer and inflammation: the evidence. Histopathology. 2012;60(1):199-215.
  • 22. Keizman D, Gottfried M, Ish-Shalom M, et al. Pretreatment neutrophil-to-lymphocyte ratio in metastatic castration-resistant prostate cancer patients treated with ketoconazole: association with outcome and predictive nomogram. Oncologist. 2012;17(12):1508-14.
  • 23. Gu X, Gao X, Li X, et al. Prognostic significance of neutrophil-to-lymphocyte ratio in prostate cancer: evidence from 16,266 patients. Scientific reports. 2016;6:22089.
  • 24. Wang J, Zhou X, He Y, et al. Prognostic role of platelet to lymphocyte ratio in prostate cancer: A meta-analysis. Medicine (Baltimore). 2018;97(40):e12504.
  • 25. Guo J, Fang J, Huang X, et al. Prognostic role of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in prostate cancer: A meta-analysis of results from multivariate analysis. International journal of surgery (London, England). 2018;60:216-23.
  • 26. Gokce MI, Hamidi N, Suer E, et al. Evaluation of neutrophil-to-lymphocyte ratio prior to prostate biopsy to predict biopsy histology: Results of 1836 patients. Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2015;9(11-12):E761-5.
  • 27. Kaynar M, Yildirim ME, Gul M, et al. Benign prostatic hyperplasia and prostate cancer differentiation via platelet to lymphocyte ratio. Cancer Biomarkers. 2015;15:317-23.
  • 28. Kamali K, Ashrafi M, Shadpour P, et al. The role of blood neutrophil count and the neutrophil-to-lymphocyte ratio as a predictive factor for prostate biopsy results. Urologia. 2018;85(4):158-62.
  • 29. Eren H. Predictive Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratio Measured Prior to Prostate Biopsy. Journal of Urological Surgery. 2020;7(1):37-41.
There are 29 citations in total.

Details

Primary Language English
Subjects Urology
Journal Section Original Article
Authors

Mehmet Kutlu Demirkol 0000-0003-1678-9889

Osman Barut 0000-0002-8296-9717

Enes Baki Bilecan This is me 0000-0003-1094-397X

Tayfun Şahinkanat 0000-0001-8128-0275

Ömer Faruk Boran 0000-0002-0262-9385

Mustafa Metin 0000-0003-4455-5318

Sefa Resim 0000-0003-1652-4792

Publication Date June 29, 2021
Published in Issue Year 2021 Volume: 16 Issue: 2

Cite

Vancouver Demirkol MK, Barut O, Bilecan EB, Şahinkanat T, Boran ÖF, Metin M, et al. An inflammatory marker for predicting prostate cancer in prostate biopsy: monocyte-to-lymphocyte ratio. New J Urol. 2021;16(2):101-9.