Wang Hao, Xie Dawei, Wang Siqi, Wu Liyang, Chu Yifan, Yang Pushen, He Weifeng, Wang Jianwen
Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Urology, Capital Medical University Daxing Teaching Hospital, Beijing, China.
Cancer Rep (Hoboken). 2024 Jan 23;7(2):e1977. doi: 10.1002/cnr2.1977.
Prostate cancer (PCa) is one of the most common malignant tumors in men, and laparoscopic radical prostatectomy (LRP) is commonly used to treat localized and advanced PCa. Positive surgical margin (PSM) is one of the most frequent problems faced by surgeons.
This study aimed to explore the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) in predicting PSM after LRP.
Three hundred and twenty patients with PCa were admitted and underwent LRP in Beijing Chaoyang Hospital from January 2017 to June 2023. Patients were randomly divided into a training set (225 cases) and a validation set (95 cases) in a 7:3 ratio. NLR, PLR, and RDW were significantly higher in the PSM group than in the negative surgical margins (NSM) group. In addition, the NLR, PLR, and RDW values correlated with clinical T stage, Gleason score, and seminal vesicle invasion in the PSM group. In training set, ROC curve analysis revealed that the optimal cutoff values of NLR, PLR, and RDW for predicting postoperative PSM in PCa were 2.31, 115.40, and 12.85%, respectively. Multivariate Logistic regression analysis showed NLR and RDW were the clinical independent predictors. The area under the curve (AUC, 0.770, 95% CI 0.709-0.831) for postoperative PSM was the highest when a combination of the three parameters was used, with sensitivity and specificity of 62.5% and 85.2%, respectively. In validation set, the AUC values for NLR, PLR, RDW and the three markers combined were 0.708, 0.675, 0.723, and 0.780, respectively. Correlation analysis showed that in the PSM group, NLR was positively correlated with PLR and RDW, and PLR was positively correlated with RDW. By contrast, in the NSM group, a positive association was only found between NLR and PLR.
Higher preoperative NLR, PLR, and RDW values were associated with postoperative PSM. Additionally, the three markers combined may be useful to predict PSM.
前列腺癌（PCa）是男性最常见的恶性肿瘤之一，腹腔镜前列腺癌根治术（LRP）常用于治疗局限性和晚期PCa。手术切缘阳性（PSM）是外科医生面临的最常见问题之一。
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和红细胞分布宽度（RDW）在预测LRP术后PSM中的价值。
2017年1月至2023年6月，320例PCa患者在北京朝阳医院入院并接受LRP。患者按7:3的比例随机分为训练集（225例）和验证集（95例）。PSM组的NLR、PLR和RDW显著高于手术切缘阴性（NSM）组。此外，PSM组的NLR、PLR和RDW值与临床T分期、Gleason评分和精囊侵犯相关。在训练集中，ROC曲线分析显示，PCa术后预测PSM的NLR、PLR和RDW的最佳截断值分别为2.31、115.40和12.85%。多因素Logistic回归分析显示NLR和RDW是临床独立预测因素。当使用三个参数联合时，术后PSM的曲线下面积（AUC，0.770，95%CI 0.709-0.831）最高，敏感性和特异性分别为62.5%和85.2%。在验证集中，NLR、PLR、RDW及三者联合的AUC值分别为0.708、0.675、0.723和0.780。相关性分析显示，在PSM组中，NLR与PLR和RDW呈正相关，PLR与RDW呈正相关。相比之下，在NSM组中，仅在NLR和PLR之间发现正相关。
术前较高的NLR、PLR和RDW值与术后PSM相关。此外，三者联合可能有助于预测PSM。
