Caglayan Volkan, Onen Efe, Avci Sinan, Sambel Murat, Kilic Metin, Oner Sedat, Aydos Mustafa Murat, Yıldız Halil Emre
University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa.
Arch Ital Urol Androl. 2019 Jan 17;90(4):270-275. doi: 10.4081/aiua.2018.4.270.
To evaluate the diagnostic value of serum inflammation markers derived from complete blood count in diagnosis of prostate cancer (PCa).
We retrospectively analyzed the data of 621 patients who underwent prostate biopsy between March 2013 and April 2018. Age, prostate specific antigen (PSA), free PSA, platelet count, neutrophil count, lymphocyte count, monocyte count, prostate volume (PV) and pathology result of the patients were recorded. Patients were grouped as benign prostatic hyperplasia (BPH), prostatitis and PCa. Patients were also grouped according to PSA values, as PSA < 4 , PSA 4-10 and PSA > 10 ng/dl.
The mean lymphocyte-to-monocyte ratio (LMR) value of the patients with PCa was significantly lower in the entire cohort (p = 0.047). In the PSA 4-10 ng/dl range, LMR value wassignificantly lower in patients with PCa than those with BPH or prostatitis (p = 0.012). In this PSA range, free/total PSA ratio and LMR were significant factors to predict PCa. The cut-off values of LMR, free/total PSA were 3.05 and 0.15 respectively. The sensitivities, spesificities, positive predictive values (PPV) and negative predictive values using LMR cut-off, free/total PSA cut-off and their combination were assessed. Specificity and PPV of the combination group were higher (97.2%, 83.3% respectively) compared to free/total PSA cut-off group (91.6%, 76.6%) and LMR cut-off group (67.8%, 43.7%).
LMR is a useful tool at detecting PCa especially in patients with PSA value between 4 and 10 ng/dl. The combination of free/total PSA ratio and LMR improves the diagnostic accuracy more than the use of free/total PSA ratio alone.
评估全血细胞计数衍生的血清炎症标志物在前列腺癌（PCa）诊断中的价值。
回顾性分析2013年3月至2018年4月间621例行前列腺穿刺活检患者的数据。记录患者的年龄、前列腺特异性抗原（PSA）、游离PSA、血小板计数、中性粒细胞计数、淋巴细胞计数、单核细胞计数、前列腺体积（PV）及病理结果。患者分为良性前列腺增生（BPH）、前列腺炎和PCa组。患者还根据PSA值分为PSA<4、PSA 4-10和PSA>10 ng/dl组。
在整个队列中，PCa患者的平均淋巴细胞与单核细胞比值（LMR）显著降低（p=0.047）。在PSA 4-10 ng/dl范围内，PCa患者的LMR值显著低于BPH或前列腺炎患者（p=0.012）。在此PSA范围内，游离/总PSA比值和LMR是预测PCa的重要因素。LMR、游离/总PSA的截断值分别为3.05和0.15。评估了使用LMR截断值、游离/总PSA截断值及其组合的敏感性、特异性、阳性预测值（PPV）和阴性预测值。与游离/总PSA截断值组（91.6%，76.6%）和LMR截断值组（67.8%，43.7%）相比，联合组的特异性和PPV更高（分别为97.2%，83.3%）。
LMR是检测PCa的有用工具，尤其是在PSA值介于4至10 ng/dl之间的患者中。游离/总PSA比值与LMR联合使用比单独使用游离/总PSA比值能提高诊断准确性。
