Department of Urology. Bakirkoy Dr. Sadi Konuk Training and Research Hospital. Istanbul. Turkey.
Department of Urology. Arnavutkoy State Hospital. Istanbul, Turkey.
Arch Esp Urol. 2021 Jul;74(6):599-605.
We aimed to determine the parameters that predict Gleason Score (GS) upgrading in patients undergoing robot-assisted laparoscopic radical prostatectomy (RARP) and especially the ability of neutrophile to lymphocyte ratio (NLR) in predicting the upgrading.
Patients who underwent RARP for prostate cancer in our clinic between January 2013 and January 2018 were retrospectively analyzed. Patients' demographic data, preoperative and postoperative parameters were all recorded in the database. NLR was calculated by dividing the absolute neutrophil count (NC) by the absolute lymphocyte count (LC). Patients were classified as low, moderate and high risk according to the National Comprehensive Cancer Network (NCNN) Guidelines. Any increase in GS between biopsy results and radical prostatectomy specimens were consideredas an GS upgrading.
After applying the inclusion and exclusion criteria, a total of 571 patients, 205 patients without GS upgrading (Group 1) and 366 patients with GS upgrading (Group 2), were included. The mean preoperative PSA values and prostate volumes were 10.8 ± 8 ng/dL and 45 ± 18.8 ml, respectively. Group 2 had a significantly high NC and NLR, significantly low platelet count (PC) and LC, (p=0.0001, 0.0001, 0.001 and0.002, respectively). Group 2 was found to have significantly higher positive surgical margin (PSM), extraprostatic extension (EPE) and seminal vesical invasion (SVI) (p<0.001). There was no significant correlation between the parameters of NLR and PSM, EPE, SVI, and lymph node invasion (LNI). Binomial logistic regression showed patients with increased NLR had 1.68 times higher odds to exhibit an upgrade in GS in the post-surgical histopathological analysis.
NLR calculated preoperatively is an easy diagnostic method that can predict GS upgrading in patients scheduled for radical prostatectomy for prostate cancer.
我们旨在确定在接受机器人辅助腹腔镜前列腺根治性切除术（RARP）的患者中预测 Gleason 评分（GS）升级的参数，特别是中性粒细胞与淋巴细胞比值（NLR）预测升级的能力。
对 2013 年 1 月至 2018 年 1 月期间在我院接受 RARP 治疗前列腺癌的患者进行回顾性分析。记录患者的人口统计学数据、术前和术后参数，并将其录入数据库。NLR 通过将绝对中性粒细胞计数（NC）除以绝对淋巴细胞计数（LC）来计算。根据美国国家综合癌症网络（NCNN）指南，患者被分为低危、中危和高危。活检结果与根治性前列腺切除术标本之间任何 GS 升高均被认为是 GS 升级。
应用纳入和排除标准后，共纳入 571 例患者，其中 205 例无 GS 升级（第 1 组），366 例 GS 升级（第 2 组）。第 2 组的平均术前 PSA 值和前列腺体积分别为 10.8±8ng/dL 和 45±18.8ml，第 2 组的 NC 和 NLR 显著较高，血小板计数（PC）和 LC 显著较低（p=0.0001，0.0001，0.001 和 0.002）。第 2 组的阳性切缘（PSM）、前列腺外延伸（EPE）和精囊侵犯（SVI）显著更高（p<0.001）。NLR 与 PSM、EPE、SVI 和淋巴结侵犯（LNI）之间无显著相关性。二项逻辑回归显示，NLR 升高的患者在术后组织病理学分析中 GS 升级的几率增加 1.68 倍。
术前计算 NLR 是一种简单的诊断方法，可预测接受前列腺癌根治性切除术的患者的 GS 升级。
