中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）在预测下尿路症状患者及血清前列腺特异性抗原（sr.PSA）升高患者前列腺癌（CaP）中的作用
Role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in predicting carcinoma prostate (CaP) in patients with lower urinary tract symptoms and raised serum prostate-specific antigen (sr.PSA).
作者信息
Mehta Sejal, Ketkar Mrunal, Jain D K
机构信息
Senior Resident (General Surgery), Bharati Vidyapeeth (Deemed to be University), Pune, India.
Professor & Head (General Surgery), Bharati Vidyapeeth (Deemed to be University), Pune, India.
出版信息
Med J Armed Forces India. 2024 Dec;80(Suppl 1):S160-S166. doi: 10.1016/j.mjafi.2023.03.001. Epub 2023 May 16.
BACKGROUND
Carcinoma prostate (CaP) is second most common cancer and sixth leading cause of cancer-related mortality among men worldwide. Prostate-specific antigen (sr. PSA) levels are prostate specific, not cancer specific. Therefore, finding non-invasive novel markers that can detect clinically significant CaP for preventing unnecessary biopsies is needed. Relation between host inflammatory responses and tumour has been increasingly recognized in various carcinomas. Many follow-up studies used neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with sr. PSA level for CaP detection in India. The present study explored the use of these biomarkers in predicting CaP in patients with lower urinary tract symptoms (LUTS).
METHODS
This prospective observational analytical study included 220 patients who underwent prostate biopsy for LUTS and suspected CaP between 2019 and 2021. Pearson's correlation (r) was used to find association between various attributes. Receiver operating characteristic curve analysis was performed to determine cut-off values and find sensitivity, specificity, positive and negative predictive value of NLR and PLR. P-value <0.05 was considered statistically significant (α = 5%).
RESULTS
Out of 263 patients, 43 were excluded. Among remaining 220 study patients, 166 had BPH and 54 CaP. Median values of NLR and PLR were significantly higher in CaP patients. There was a strong positive correlation noted between NLR, PLR, and CaP groups. Areas under receiver operating characteristic curve of NLR (p = 0.001) and PLR (p < 0.001) for predicting CaP were statistically significant, with cut-off values of >3.44 and > 165.96, respectively.
CONCLUSION
In present study, we found significant increase in NLR and PLR in CaP patients. These parameters could be useful as pre-prostate biopsy predictors of CaP and help avoid unnecessary biopsies.
背景
前列腺癌（CaP）是全球男性中第二常见的癌症，也是癌症相关死亡率的第六大主要原因。前列腺特异性抗原（sr. PSA）水平是前列腺特异性的，而非癌症特异性的。因此，需要找到能够检测出具有临床意义的CaP以避免不必要活检的非侵入性新型标志物。宿主炎症反应与肿瘤之间的关系在各种癌症中已得到越来越多的认识。在印度，许多随访研究使用中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）并结合sr. PSA水平来检测CaP。本研究探讨了这些生物标志物在预测下尿路症状（LUTS）患者CaP中的应用。
方法
这项前瞻性观察性分析研究纳入了2019年至2021年间因LUTS和疑似CaP而接受前列腺活检的220名患者。采用Pearson相关性（r）分析来确定各种属性之间的关联。进行受试者操作特征曲线分析以确定临界值，并找出NLR和PLR的敏感性、特异性、阳性和阴性预测值。P值<0.05被认为具有统计学意义（α = 5%）。
结果
在263名患者中，43名被排除。在其余220名研究患者中，166名患有良性前列腺增生（BPH），54名患有CaP。CaP患者的NLR和PLR中位数显著更高。NLR、PLR与CaP组之间存在强烈的正相关。NLR（p = 0.001）和PLR（p < 0.001）预测CaP的受试者操作特征曲线下面积具有统计学意义，临界值分别为>3.44和>165.96。
结论
在本研究中，我们发现CaP患者的NLR和PLR显著升高。这些参数可作为前列腺活检前CaP的预测指标，有助于避免不必要的活检。
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