Diagnostic Value of Platelet–To-Lymphocyte Ratio in Prostate Cancer

Abstract

BACKGROUND: Previous studies demonstrated the promising value of platelet-to-lymphocyte (PLR) in prostate cancer.
 AIM: This study was conducted to evaluate its pre-biopsy values in predicting prostate cancer.
 METHODS: We included all benign prostatic hyperplasia (BPH) and prostate cancer (PCa) patients who underwent a prostate biopsy in Adam Malik Hospital between August 11th 2011 and August 31st 2015. The relationship between pre-biopsy variables which could be affecting the percentage of prostate cancer risk was evaluated, including age, prostate-specific antigen (PSA) level, and prostate volume (EPV). The PLR was calculated from the ratio of related platelets with their absolute lymphocyte counts. The values then analysed to evaluate their associations with the diagnosis of BPH and PCa.
 RESULTS: As many as 298 patients consisted of 126 (42.3%) BPH and 172 PCa (57.7%) patients are included in this study. Mean age for both groups are 66.36 ± 7.53 and 67.99 ± 7.48 years old (p = 0.64), respectively. There are statistically significant differences noted from PSA (19.28 ± 27.11 vs 40.19 ± 49.39), EPV (49.39 ± 23.51 vs 58.10 ± 30.54), PLR (160.27 ± 98.96 vs 169.55 ± 78.07), and NLR (3.57 ± 3.23 vs 4.22 ± 2.59) features of both groups (p < 0.05). The AUC of PLR is 57.9% with a sensitivity of 56.4% and specificity of 55.6% in the cut-off point of 143 (p = 0.02). Besides, the NLR cut-off point of 3.08 gives 62.8% AUC with 64.5% sensitivity and 63.5% specificity. We asked for permission from the preceding authors of Indonesian Prostate Cancer Risk Calculator (IPCRC) and calculated its value from 98 randomised patients consist of 45 (45.92%) BPH and 53 (54.08%) PCa. We found a comparable value between PLR/NLR with IPCRC in predicting prostate cancer (AUC of 67.6%, 75.3%, and 68.4%, respectively) with a statistically significant difference of all value in both groups (p < 0.05).
 CONCLUSIONS: PLR gives promising value in predicting prostate cancer in suspected patients. We suggest a further prospective study to validate its diagnostic values so it can be used as applicable routine calculation.

WITHDRAWN: Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Alone or Combined with Prostate-Specific Antigen for the Diagnosis of Clinically Significant Prostate Cancer

“…Recently, various blood parameters (NLR, PLR, LMR, and MPV) [8,9,10,11,12,13] have been utilized to predict the diagnosis of PCa, clinically signi cant PCa, and its outcomes. However using these blood parameters is still a matter of debate and controversial as different studies argued that they are unreliable in detecting PCa [14,15].…”

“…In Korean patients with gray-zone PSA, NLR was associated with PCa detection and GS ≥ 4 + 3 cancer [11]. Adhyatma et al discovered that prebiopsy PLR is valuable in detecting PCa [12]. Mehmet et al reported that aggressive PCa is associated with NLR increase; however, they suggested that prostatitis limited the use of NLR in detecting PCa [13].…”

“…The utilization of prebiopsy blood parameters to identify PCa and its outcomes remains controversial. Several previous approved the use of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) [8,9,10,11,12,13], whereas other studies disagreed as upon comparison, other clinical parameters such as age, PSA, PSAD, free PSA, and f/t PSA were better markers [14,15,16].…”

The Value of Inflammatory Cell Count and Its Ratio in the Diagnosis of Prostate Cancer

“…But a prospective study found that the neutrophil/lymphocyte ratio did not discriminate between benign and malignant prostatic disease in patients with a PSA between 4-10 ng/ml [19]. A retrospective study by Adhyatma KP et al found that PLR gives promising value in predicting prostate cancer in suspected patients [20]. A retrospective study by Kaynar M et al found that statistically signi cant differences were observed in the mean PLR values only if the PSA level was 10 ng/ml and above in the BPH and PCa groups [21].…”

HALP Score and Albumin Levels in Men with Prostate Cancer and Benign Prostate Hyperplasia

“…14 Urokinase plasminogen activation (uPA and uPAR) is involved in PCa progression, however it seems to be helpful in predicting poor pathologic characteristics rather than diagnosis of PCa. 15 There have also been a number of studies about the diagnostic role of the platelet-to-lymphocyte ratio (PLR) [16][17][18][19] ; the neutrophil-to-lymphocyte ratio (NLR) 20 and the combined use of PSA, mean platelet volume (MPV), and platelet distribution width (PDW). 21 These studies found these values to be associated with a poor prognosis in PCa patients.…”