炎症标志物对预测接受主动监测的前列腺癌患者根治性治疗的意义。
Significance of Inflammation Markers to Predict Curative Treatment for Prostate Cancer Patients on Active Surveillance.
作者信息
Serkan Yenigürbüz, Caner Ediz, Serkan Akan, Bulent Kati, Yasin Vural, Adem Alcin, Omer Yilmaz
机构信息
Department of Urology, Sultan 2. Abdulhamid Han Education and Research Hospital, Istanbul, Turkey.
Department of Urology, Fatih Sultan Mehmet Han Education and Research Hospital, Istanbul, Turkey.
出版信息
J Clin Lab Anal. 2025 Jul;39(13):e70059. doi: 10.1002/jcla.70059. Epub 2025 May 31.
PURPOSE
Active surveillance (AS) strategy aims to avoid unnecessary or excessive early treatment in patients at a low risk for prostate cancer (PCa). However, a biomarker that can predict the need for early curative treatment in patients under AS has not been identified to date. In this study, we aimed to investigate the potential of inflammatory biomarkers in predicting the requirement of curative treatment in the early period in patients under AS.
MATERIALS AND METHODS
This study included a total of 83 patients with the diagnosis of PCa and under AS. Patient age, prostate-specific antigen (PSA) level, prostate volume (PV), PSA density (PSAD), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and follow-up period were compared between the groups.
RESULTS
There was a significant difference between the two groups in terms of PSAD, NLR, PLR and SII (p = 0.037, p = 0.046, p = 0.008, p = 0.004 and p = 0.005, respectively). The cut-off value determined by performing ROC analysis to evaluate the levels that predict the need for curative treatment before AS was 0.125 for PSAD (sensitivity: 61.8%, specificity: 61.2%), 2.01 for NLR (sensitivity: 67.6%, specificity: 55.1%), 115.49 for PLR (sensitivity: 73.5%, specificity: 59.2%) and 465.40 for SII (sensitivity: 70.6%, specificity: 59.2%).
CONCLUSIONS
The analysis of PSAD, NLR, PLR and SII before making the decision to conduct AS can guide clinicians regarding curative treatment in the early period.
目的
主动监测（AS）策略旨在避免对前列腺癌（PCa）低风险患者进行不必要或过度的早期治疗。然而，迄今为止尚未确定一种能够预测接受AS治疗的患者是否需要早期根治性治疗的生物标志物。在本研究中，我们旨在探讨炎症生物标志物在预测接受AS治疗的患者早期根治性治疗需求方面的潜力。
材料与方法
本研究共纳入83例诊断为PCa且接受AS治疗的患者。比较了两组患者的年龄、前列腺特异性抗原（PSA）水平、前列腺体积（PV）、PSA密度（PSAD）、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、全身免疫炎症指数（SII）及随访时间。
结果
两组在PSAD、NLR、PLR和SII方面存在显著差异（分别为p = 0.037、p = 0.046、p = 0.008、p = 0.004和p = 0.005）。通过进行ROC分析确定的用于评估预测AS前根治性治疗需求水平的截断值，PSAD为0.125（敏感性：61.8%，特异性：61.2%），NLR为2.01（敏感性：67.6%，特异性：55.1%），PLR为115.49（敏感性：73.5%，特异性：59.2%），SII为465.40（敏感性：70.6%，特异性：59.2%）。
结论
在决定进行AS之前对PSAD、NLR、PLR和SII进行分析，可以为临床医生在早期根治性治疗方面提供指导。
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