Yuksel Ozgur Haki, Urkmez Ahmet, Akan Serkan, Yldirim Caglar, Verit Ayhan
Department of Urology, Fatih Sultan Mehmet, Research and Training Hospital, Istanbul, Turkey E-mail :
Asian Pac J Cancer Prev. 2015;16(15):6407-12. doi: 10.7314/apjcp.2015.16.15.6407.
To predict prostatic carcinoma using a logistic regression model on prebiopsy peripheral blood samples.
Data of a total of 873 patients who consulted Urology Outpatient Clinics of Fatih Sultan Mehmet Training and Research Hospital between February 2008 and April 2014 scheduled for prostate biopsy were screened retrospectively. PSA levels, prostate volumes, prebiopsy whole blood cell counts, neutrophil and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), biopsy results and Gleason scores in patients who had established diagnosis of prostate cancer (PCa) were evaluated.
This study was performed on a total of 873 cases, with an age range 48-76 years, divided into three groups as for biopsy results. with diagnoses of benign prostatic hyperplasia (BPH) (n=304, 34.8 %), PCa (n=265, 30.4%) and histological prostatitis (n=304; 34.8%). Intra- and intergroup comparative evaluations were performed. White blood cell and neutrophil counts in the histological prostatitis group were significantly higher than those of the BPH and PCa groups (p=0.001; p=0.004; p<0.01). A statistically significant intergroup difference was found for PLR (p=0.041; p<0.05) but not lymphocyte count (p>0.05). According to pairwise comparisons, PLR were significantly higher in the PCa group relative to BPH group (p=0.018, p<0.05, respectively). Though not statistically significant, higher PLR in cases with PCa in comparison with the prostatitis group was remarkable (p=0.067, and p>0.05, respectively).
Meta-analyses showed that in patients with PSA levels over 4 ng/ml, positive predictive value of PSA is only 25 percent. Therefore, novel markers which can both detect clinically significant prostate cancer, and also prevent unnecessary biopsies are needed. Relevant to this issue in addition to PSA density, velocity, and PCA3, various markers have been analyzed. In the present study, PLR were found to be the additional predictor of prostatic carcinoma.
利用逻辑回归模型对活检前外周血样本进行前列腺癌预测。
回顾性筛查2008年2月至2014年4月期间在法提赫·苏丹·穆罕默德培训与研究医院泌尿外科门诊咨询并计划进行前列腺活检的873例患者的数据。评估已确诊前列腺癌（PCa）患者的前列腺特异性抗原（PSA）水平、前列腺体积、活检前全血细胞计数、中性粒细胞和血小板计数、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、活检结果及 Gleason评分。
本研究共纳入873例患者，年龄范围为48 - 76岁，根据活检结果分为三组，分别为良性前列腺增生（BPH）（n = 304，34.8%）、PCa（n = 265，30.4%）和组织学前列腺炎（n = 304；34.8%）。进行了组内和组间的比较评估。组织学前列腺炎组的白细胞和中性粒细胞计数显著高于BPH组和PCa组（p = 0.001；p = 0.004；p < 0.01）。发现PLR存在统计学显著的组间差异（p = 0.041；p < 0.05），但淋巴细胞计数无差异（p > 0.05）。根据两两比较，PCa组的PLR显著高于BPH组（分别为p = 0.018，p < 0.05）。虽然与前列腺炎组相比，PCa病例的PLR较高但无统计学显著性（分别为p = 0.067，p > 0.05）。
荟萃分析表明，PSA水平超过4 ng/ml的患者中，PSA的阳性预测值仅为25%。因此，需要既能检测出具有临床意义的前列腺癌，又能避免不必要活检的新型标志物。除了PSA密度、速度和PCA3外，还分析了各种与该问题相关的标志物。在本研究中，发现PLR是前列腺癌的额外预测指标。
