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血小板与淋巴细胞比值在前列腺癌中的诊断价值

Diagnostic Value of Platelet-To-Lymphocyte Ratio in Prostate Cancer.

作者信息

Adhyatma Kharisma Prasetya, Warli Syah Mirsya

机构信息

Department of Urology, Faculty of Medicine, Sumatera Utara University, Adam Malik Hospital, Medan, Indonesia.

出版信息

Open Access Maced J Med Sci. 2019 Apr 13;7(7):1093-1096. doi: 10.3889/oamjms.2019.252. eCollection 2019 Apr 15.

Abstract

BACKGROUND

Previous studies demonstrated the promising value of platelet-to-lymphocyte (PLR) in prostate cancer.

AIM

This study was conducted to evaluate its pre-biopsy values in predicting prostate cancer.

METHODS

We included all benign prostatic hyperplasia (BPH) and prostate cancer (PCa) patients who underwent a prostate biopsy in Adam Malik Hospital between August 11th 2011 and August 31st 2015. The relationship between pre-biopsy variables which could be affecting the percentage of prostate cancer risk was evaluated, including age, prostate-specific antigen (PSA) level, and prostate volume (EPV). The PLR was calculated from the ratio of related platelets with their absolute lymphocyte counts. The values then analysed to evaluate their associations with the diagnosis of BPH and PCa.

RESULTS

As many as 298 patients consisted of 126 (42.3%) BPH and 172 PCa (57.7%) patients are included in this study. Mean age for both groups are 66.36 ± 7.53 and 67.99 ± 7.48 years old (p = 0.64), respectively. There are statistically significant differences noted from PSA (19.28 ± 27.11 vs 40.19 ± 49.39), EPV (49.39 ± 23.51 vs 58.10 ± 30.54), PLR (160.27 ± 98.96 vs 169.55 ± 78.07), and NLR (3.57 ± 3.23 vs 4.22 ± 2.59) features of both groups (p < 0.05). The AUC of PLR is 57.9% with a sensitivity of 56.4% and specificity of 55.6% in the cut-off point of 143 (p = 0.02). Besides, the NLR cut-off point of 3.08 gives 62.8% AUC with 64.5% sensitivity and 63.5% specificity. We asked for permission from the preceding authors of Indonesian Prostate Cancer Risk Calculator (IPCRC) and calculated its value from 98 randomised patients consist of 45 (45.92%) BPH and 53 (54.08%) PCa. We found a comparable value between PLR/NLR with IPCRC in predicting prostate cancer (AUC of 67.6%, 75.3%, and 68.4%, respectively) with a statistically significant difference of all value in both groups (p < 0.05).

CONCLUSIONS

PLR gives promising value in predicting prostate cancer in suspected patients. We suggest a further prospective study to validate its diagnostic values so it can be used as applicable routine calculation.

摘要

背景

既往研究表明血小板与淋巴细胞比值(PLR)在前列腺癌中具有潜在价值。

目的

本研究旨在评估其在前列腺穿刺活检前预测前列腺癌的价值。

方法

纳入2011年8月11日至2015年8月31日期间在亚当·马利克医院接受前列腺穿刺活检的所有良性前列腺增生(BPH)和前列腺癌(PCa)患者。评估可能影响前列腺癌风险百分比的穿刺活检前变量之间的关系,包括年龄、前列腺特异性抗原(PSA)水平和前列腺体积(EPV)。PLR通过相关血小板与绝对淋巴细胞计数的比值计算得出。然后分析这些值以评估它们与BPH和PCa诊断的相关性。

结果

本研究共纳入298例患者,其中126例(42.3%)为BPH患者,172例(57.7%)为PCa患者。两组的平均年龄分别为66.36±7.53岁和67.99±7.48岁(p = 0.64)。两组在PSA(19.28±27.11 vs 40.19±49.39)、EPV(49.39±23.51 vs 58.10±30.54)、PLR(160.27±98.96 vs 169.55±78.07)和中性粒细胞与淋巴细胞比值(NLR)(3.57±3.23 vs 4.22±2.59)特征方面存在统计学显著差异(p < 0.05)。PLR的曲线下面积(AUC)为57.9%,在截断值为143时,敏感性为56.4%,特异性为55.6%(p = 0.02)。此外,NLR截断值为3.08时,AUC为62.8%,敏感性为64.5%,特异性为63.5%。我们获得了印度尼西亚前列腺癌风险计算器(IPCRC)前作者的许可,并从98例随机患者中计算其值,其中45例(45.92%)为BPH患者,53例(54.08%)为PCa患者。我们发现PLR/NLR与IPCRC在预测前列腺癌方面具有可比价值(AUC分别为67.6%、75.3%和68.4%),两组所有值均存在统计学显著差异(p < 0.05)。

结论

PLR在预测疑似前列腺癌患者方面具有潜在价值。我们建议进行进一步的前瞻性研究以验证其诊断价值,以便将其用作适用的常规计算方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b245/6490494/92a33acabb3f/OAMJMS-7-1093-g001.jpg

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