Mechanism underlying the negative effect of prostate volume on the outcome of extensive transperineal ultrasound‐guided template prostate biopsy

Demura, Takayoshi; Takada, Tappei; Shimoda, Naohiko; Hioka, Takaya; Iwaguchi, Yoshihumi; Ichihara, Shin; Gotoda, Hiroko

doi:10.1002/cam4.1300

Cited by 6 publications

(3 citation statements)

References 20 publications

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“…To the best of our knowledge, this study is the first report about the predictive role of the lymphocyte‐to‐monocyte ratio in men with larger prostate volumes. This finding of the present study may be clinically meaningful, given the prostate volume may have a negative impact on the detection of prostate cancer despite the existing controversy about its role 26,27 . In this respect, considering the lymphocyte‐to‐monocyte ratio together with well‐known risk factors of clinically significant prostate cancers such as PSA before prostatic biopsies may help reduce the number of unnecessary biopsies in men with larger prostate volumes in real clinical practice.…”

Section: Discussionmentioning

confidence: 61%

Lymphocyte‐to‐monocyte ratio is a predictor of clinically significant prostate cancer at prostate biopsy

et al. 2021

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Background Inflammation plays critical roles at different stages of carcinogenesis and cancer progression. Several previous studies showed conflicting results for the predictive role of systemic inflammation markers in the detection of clinically significant prostate cancers (CSPCs). We aimed to determine the predictive roles of lymphocyte‐to‐monocyte (LMR) and eosinophil‐to‐lymphocyte ratios (ELR) in the detection of CSPC at standard 12‐core transrectal ultrasound‐guided prostate biopsy (12‐core‐TRUS‐Bx) using our large‐cohort database. Methods Clinical and pathological data of a total of 1740 men, who underwent initial standard 12‐core TRUS‐Bx, were analyzed. LMR and ELR were calculated from the prebiopsy complete blood count. Definitions of CSPC, LMR, and ELR were “Gleason grade group ≥2,” “the lymphocyte counts/the monocyte counts,” and “the eosinophil counts/the lymphocyte counts,” respectively. Results Median (interquartile range) of serum prostate‐specific antigen (PSA) level and prostatic volume before TRUS‐Bx were 7.59 (5.02–13.12) ng/ml and 38.2 (29.0–52.9) ml, respectively. Benign prostatic lesions, clinically insignificant prostate cancers (CIPCs), and CSPCs were detected in 1179 (67.8%), 180 (10.3%), and 381 (21.9%) patients, respectively. The patients with CSPCs had older age, a higher prevalence of diabetes mellitus or hypertension, a higher rate of digital rectal examination abnormality, higher serum PSA level, lower serum testosterone level, and lower LMR than those with benign lesions or CIPCs. However, there was no difference in ELR among the three (benign lesions, CIPCs and CSPCs). In all the patients, multivariate regression analysis showed that lower LMR was an independent predictor of CSPCs compared with ELR. In the subset of men with prostate volume ≥39.3 ml, lower LMR was an independent predictor of CSPCs compared with ELR. In the subset of men with prostate volume <39.3 ml, men with lower LMR showed the tendency of having a higher probability of CSPCs without any statistical significance on the contrary to ELR. Conclusions Our data indicate that LMR can play an independent predictive role in the detection of CSPCs at initial 12‐core‐TRUS‐Bx compared with ELR. The predictive role of the LMR appears to be significant for men with larger prostate volume rather than those with smaller prostate volume.

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Section: Discussionmentioning

confidence: 61%

Lymphocyte‐to‐monocyte ratio is a predictor of clinically significant prostate cancer at prostate biopsy

et al. 2021

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“…Demura et al, was found that increase in prostate volume (PV) is associated with a decrease in size and detectability of cancer lesions resulting in a decrease in biopsy yield. 20 In this study, PV in the PCa detected group was found less than the benign group.…”

Section: Discussionmentioning

confidence: 45%

What should be the PSA threshold value? 2.5 or 4 ng/mL?

Ediz¹,

Çimen

Akan³

et al. 2019

Int J Res Med Sci

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Background: In this study, author aimed to detect of threshold value of prostate-specific antigen (PSA) to distinguish malignant or benign prostatic lesions in PSA evaluation.Methods: A total of 61 patients underwent TRUSBP due to high PSA values (2.5-4 ng/mL) at the clinic between 2012-2017. Digital rectal examinations of all patients were normal. Cases with PSA elevation were divided into groups according to the pathology by benign (group 1) or malign (group 2). Author evaluated the predictive factors with the exception of digital rectal examination findings in two groups.Results: Benign prostate hyperplasia was detected in 35 patients (57.4%) and prostate adenocarcinoma was detected in 26 patients (42.6%). The patient’s age, tPSA, fPSA and PSA density were 62.07 years, 3.55 ng/mL, 0.65 ng/mL and 0.09 ng/ml2 in group 1 and 58.54 years, 3.55 ng/mL, 0.74 ng/mL and 0.10 ng/ml2 in group 2, respectively. Patient’s age was statistically significant between in two groups (p<0.05). Number of received cores and rate of f/tPSA were 12.24-12 and 20.51-18.45% in group 1 and 2, respectively. tPSA, fPSA and PSA density, number of received cores and rate of f/tPSA were similar in both groups. In group 2, prostate adenocarcinoma was most common detected with Gleason score 3+3 in 19 of 26 patients (73.1%).Conclusions: There is a need different assessment to distinguish of malignant lesions from benign lesions. Nowadays, it was impossible to make this difference in patients without digital rectal examination findings, so accepted threshold of PSA should be 2.5 ng/mL.

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“…In a study on the reduction of biopsy yield by Demura et al were found that PV is associated with a decrease in size and detectability of cancer lesions resulting in a decrease in biopsy yield. 8 For this reason, different PSA forms are utilized for biopsy prediction. In this sense, fPSA cannot be used because of close relationship with prostate volume.…”

Section: Resultsmentioning

confidence: 99%

PSA density as a parameter in prostate biopsy decision of patients with prostate sized 80 mL or larger

Ediz¹,

Çimen

Akan³

et al. 2019

Int J Res Med Sci

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Background: Patients with high prostate volume (>80 ml) and high PSA levels make it difficult to decide on prostate biopsy. In this study, author aimed to detect of predictive factors to distinguish malignant or benign prostatic lesions in patients with prostate size over 80 ml.Methods: A total of 299 patients underwent TRUSBP at the clinics between 2012-2017. Cases with prostate volume over 80 ml were divided into groups according to the pathology by benign (group 1) or malign (group 2). Author evaluated the predictive factors in two groups. Patient’s age, grading and findings of digital rectal examination, prostate volume, number of received cores, total (tPSA) and free PSA (fPSA) before biopsy, rate of percentage of free to total prostate specific antigen (f/tPSA) and PSA density was compared in both groups.Results: Benign prostate hyperplasia was detected in 217 patients (72.58%) and prostate adenocarcinoma was detected in 82 patients (27.42%). The patient’s age, tPSA, fPSA and PSA density were 63.81 years, 9.71 ng/ml, 1.78 ng/ml and 0.10 g/ml2 in group 1 and 69.10 years, 38.32 ng/ml, 5.86 ng/ml and 0.42 ng/ml2 respectively. Patient’s age, tPSA, fPSA and PSA density was statistically significant between in two groups (p<0,05). Number of received cores and rate of f/tPSA were 14.02-13.84% and 19.06-17.62% in group 1 and 2, respectively and was not statistically significant. In group 2, prostate adenocarcinoma was most common detected with Gleason score 4+3 in 21 of 82 patients (25.6%).Conclusions: High prostate volume (>80 ml) has a significant influence in PSA values and results of the biopsy, PSA density is extremely important in performing prostate biopsy decisions.

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Mechanism underlying the negative effect of prostate volume on the outcome of extensive transperineal ultrasound‐guided template prostate biopsy

Cited by 6 publications

References 20 publications

Lymphocyte‐to‐monocyte ratio is a predictor of clinically significant prostate cancer at prostate biopsy

Lymphocyte‐to‐monocyte ratio is a predictor of clinically significant prostate cancer at prostate biopsy

What should be the PSA threshold value? 2.5 or 4 ng/mL?

PSA density as a parameter in prostate biopsy decision of patients with prostate sized 80 mL or larger

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