Neutrophil-to-lymphocyte ratio predicts prostatic carcinoma in men undergoing needle biopsy

Abstract

Neutrophil-to-lymphocyte ratio (NLR), a simple marker of systemic inflammatory response, has been demonstrated as an independent prognosticator for some solid malignancies, including prostate cancer. In the present study, we evaluated the role of NLR in men who underwent prostate needle biopsy for their initial diagnosis of prostatic carcinoma. Both complete blood counts and free/total (F/T) prostate-specific antigen (PSA) ratio were examined in a total of 3,011 men in our institution. Of these, 1,207 had a PSA level between 4 and 10 ng/mL, and 357 of 810 who subsequently underwent prostate needle biopsy were found to have prostatic adenocarcinoma. NLR value was significantly higher in men with PSA of ≥ 20 ng/mL than in those with PSA of < 20 ng/mL (p < 0.001). NLR was also significantly higher in men with positive biopsy than in those with negative biopsy (p < 0.001). Using NLR cut-off point of 2.40 determined by the AUROC curve, positive/negative predictive values of NLR alone and NLR combined with F/T PSA ratio (cut-off: 0.15) were 56.6%/60.8% and 80.7%/60.1%, respectively. Multivariate analysis revealed that not only F/T PSA ratio (HR = 3.13) but also NLR (HR = 2.21) was an independent risk factor for prostate cancer. NLR is thus likely elevated in patients with prostate cancer. Accordingly, NLR, with or without combination with F/T PSA ratio, may function as a new biomarker to predict prostate cancer in men undergoing prostate needle biopsy.

Baseline neutrophil‑to‑lymphocyte ratio predicts the prognosis of castration‑resistant prostate cancer treated with abiraterone acetate

“…The NLR has been suggested to be an indicator for the general immune response to various diseases, and in cancer, the inflammatory response has been reported to play an important role in the occurrence and development by immune microenvironment in tumor cells (5,6). Previous reports have shown the NLR to be a parameter reflecting the efficacy of treatments and the prognosis in prostate cancer (9,22). We previously reported that the pretreatment NLR in cases of metastatic prostate cancer predicts both the cancer-specific survival and OS (4).…”

The neutrophil-to-lymphocyte ratio is an effective prognostic marker in localized upper urinary tract urothelial carcinoma treated with nephroureterectomy

“…In particular, C-reactive protein as a systemic inflammation marker was reported to be a poor prognostic factor in several types of cancers [6,7]. Others and we have also revealed that neutrophil-to-lymphocyte ratio (NLR) is an independent prognostic factor in various solid malignancies, including renal cell carcinoma, bladder urothelial carcinoma, and prostatic carcinoma [8][9][10][11][12][13]. Of note, NLR can be easily calculated from complete blood counts (CBCs) in the peripheral blood, and this parameter can be used both pre-and post-operatively.…”

Author reply: The neutrophil-to-lymphocyte ratio in clinical practice

“…6 Recently, further studies investigating the role of NLR in the pre-biopsy setting were published. 1,7 In these studies, higher NLR values were found to be associated with higher rates of prostate cancer. There is also one study focusing on and early-stage and low-risk prostate cancer.…”