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

Abstract

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.

Optimization of prostate cancer patient lymph node staging via the integration of neutrophil–lymphocyte ratios, platelet–lymphocyte ratios, and 68Ga‐PSMA‐PET‐derived SUVmax values

“…We identified NLR and PLR as potential predictors of LNM in PCa based on ROC analysis and multivariate regression analysis, for which we observed that NLR (cutoff: 1.72) and PLR (cutoff: 83.305) were more likely to predict LNM when they were lower than the optimal cutoff value, though there was not super high sensitivity for hematological indices. Increases in PLR and NLR, as well as decreases in LMR, have been related to poorer overall survival outcomes in many cancers including PCa, 36,37 contradicting our results by a certain extent. We speculate that these differences may be associated with the stimulation of lymphocyte release from lymph nodes into the peripheral blood following tumor cell metastasis to these nodes.…”

“…A growing number of studies have found 68 Ga-PET/CT to offer significant value when diagnosing LNM. [25][26][27][28] As one of the primary Increases in PLR and NLR, as well as decreases in LMR, have been related to poorer overall survival outcomes in many cancers including PCa, 36,37 contradicting our results by a certain extent. We speculate that these differences may be associated with the stimulation of lymphocyte release from lymph nodes into the peripheral blood following tumor cell metastasis to these nodes.…”

Association Between Pre-Treatment and Post-Treatment 3-Month Red Cell Distribution Width with Three-Year Prognosis of Prostate Cancer

“…20,21 Many research groups have investigated the predictive and prognostic roles of peripheral blood inflammatory parameters in prostate cancer. [22][23][24] Cho et al 23 reported that the lymphocyte-to-monocyte ratio is a predictor of clinically significant prostate cancer on prostate biopsy. Bauckneht et al 24 also found that a higher neutrophil-to-lymphocyte ratio and systemic inflammation index predicted worse OS in patients with prostate cancer.…”

Monosit-lenfosit oranı, prostat kanserinin başka bir göstergesi olabilir mi?

“…(3) In addition, the high cost of such additional approaches is the greatest obstacle to their widespread use in clinical practice. (4) It is known that low IPSS score and positive rectal examination (stiffness) increase the probability of being diagnosed with cancer in patients with PSA levels in the gray zone. (5) But there is still a need for markers that can be measured with a low cost in a non-invasive manner, especially to identify clinically significant PCa (csPCa).…”

“…*Statistically significant at p<0.05.DÜNDAR & ERKAN : MLR Predicts Prostate Cancer ne system, is associated with a poor prognosis in various cancers. (16) There are few studies in the literature that draw attention to the role of MLR in the prediction of PCa (4,11,12). In this retrospective study, we evaluated whether MLR had a potential role as a biomarker of PCa activity based on clinicopathological data.…”