The preoperative neutrophil‐to‐lymphocyte ratio is not a marker of prostate cancer characteristics but is an independent predictor of biochemical recurrence in patients receiving radical prostatectomy

Abstract

The neutrophil‐to‐lymphocyte ratio (NLR) has been reported to be a prognostic marker in prostate cancer. In this study, we assessed the association between preoperative NLR and the clinicopathological characteristics, biomolecular features and prognosis of patients with localized prostate cancer treated with radical prostatectomy. A total of 994 subjects were retrospectively enrolled, and the histological specimens of 210 patients were retrieved for constructing a tissue microarray. Immunohistochemistry was then performed to assess the expression of AR, ERG, PTEN, p‐AKT, Bcl‐2, Beclin‐1, Ki‐67, CD3, CD4, CD8, IFN‐γ and TNF‐α. No significant differences in the NLR distributions among clinicopathological variables were observed (P > 0.05) when the original NLR data were utilized. When we dichotomized the NLR value into the high‐NLR group (NLR ≥ 2) and low‐NLR group (NLR < 2), we found that the patients in the high‐NLR group had more prostate capsule invasion (P = 0.047). Additionally, no significant correlation was found between the NLR and infiltrating CD3+ cells, the CD4/CD8 ratio, AR, ERG, PTEN, p‐AKT, Bcl‐2, Beclin‐1, Ki‐67, IFN‐γ or TNF‐α (P > 0.05). When we analyzed the data of patients without postoperative adjuvant hormone therapy or radiotherapy, univariate and multivariate survival analysis indicated that a high NLR was a predictor of better BCR‐free survival (P < 0.05). When analyzing the entire cohort, univariate survival analysis showed that the high‐NLR group had significantly poorer overall survival (P < 0.05). In conclusion, NLR cannot reflect prostate cancer characteristics or the local immune microenvironment, but a high NLR can serve as an independent predictor of better BCR.

The Values of Systemic Immune-Inflammation Index and Neutrophil–Lymphocyte Ratio in Predicting Biochemical Recurrence in Patients With Localized Prostate Cancer After Radical Prostatectomy

“…and Zhao et al. ( 25 , 29 ). NLR ≥2.62 was significantly associated with poorer BCR-free survival according to Kaplan–Meier analysis and Cox regression analysis, but not associated with clinicopathological outcomes.…”

Evaluation of the Prognostic Capacity of a Novel Survival Marker in Patients with Sinonasal Squamous Cell Carcinoma

“…The ratio of neutrophils to lymphocytes obtained from the peripheral blood was shown to negatively predict survival outcome in different malignancies, including non-small-cell lung cancer [ 26 ], rectal cancer [ 27 ], and even adenoid-cystic carcinoma [ 28 ]. In addition to being an indicator of the immunological response, NLR should also reflect the degree of cancer-related inflammation [ 29 ]. As aforementioned, the research on the prognostic significance of NLR in cancer started when the role of leukocytes in cancer development was first investigated and leukocytes in the tumor environment were first discovered [ 18 ].…”

Systemic immune responses are associated with molecular characteristics of circulating tumor cells in head and neck squamous cell carcinoma

“…These findings imply that lymphocyte-mediated systemic immune responses may contribute to the prevention of distant metastasis. So far, several studies have investigated the relationship between systemic immune-related markers and primary tumor characteristics using immunohistochemistry or molecular analysis; however, it seems that no meaningful correlations have yet been observed (23)(24)(25). In the dynamic multistep process of colonization of distant organs, CTCs that disseminate in the bloodstream and seed new tumors at distant organ sites might have acquired a status of dormancy in the peripheral bloodstream.…”