title: Low serum neutrophil count predicts a positive prostate biopsy.
abstract: BACKGROUND
  Asymptomatic prostatic inflammation may cause increased PSA in some men, leading to unnecessary prostate biopsy. We investigated whether the differential white cell count could predict the result of prostate biopsy.
  
  
  METHODS
  Prostate needle biopsy was carried out in 323 Japanese men with elevated PSA levels or abnormal digital rectal findings. White blood cell count (WBC), differential white cell count (neutrophils, lymphocytes, basophils, eosinophils, and monocytes), and serum C-reactive protein level were assessed for associations with biopsy findings.
  
  
  RESULTS
  In all, 203 (62.1%) were positive for prostate cancer. WBC, neutrophil count, age, PSA, prostate volume, and PSA density (PSAD) were associated with the results of biopsy (P<0.05). Multivariate analysis showed that neutrophil count, age, PSA, prostate volume and PSAD were independent predictors. When the cut-off neutrophil count was set at 2900 μl(-1), 78 of 104 men (75.0%) with a count below this value had a positive biopsy, while 125 of 219 (57.0%) men with a count above this value were positive. The area under the receiver-operator characteristics curve (AUC) for the predicted probability of a positive biopsy for prostate cancer according to the optimum logistic model was 0.83 (95% confidence interval (CI) 0.78-0.87), while the AUC for PSA was 0.70 (95% CI 0.64-0.76) and that for PSAD was 0.79 (95% CI 0.74-0.84).
  
  
  CONCLUSIONS
  An elevated neutrophil count may be a good indicator of a benign prostate biopsy. Men with a low neutrophil count and an increase of serum PSA should strongly be considered for biopsy.
authors: Department of Urology, Osaka General Medical Center, Osaka, Japan. kazufujita2@gmail.com
authors: K
authors: K
authors: Fujita
authors: R
authors: R
authors: Imamura
authors: G
authors: G
authors: Tanigawa
authors: M
authors: M
authors: Nakagawa
authors: T
authors: T
authors: Hayashi
authors: N
authors: N
authors: Kishimoto
authors: M
authors: M
authors: Hosomi
authors: S
authors: S
authors: Yamaguchi
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000378:metabolism; D006801:Humans; D007610:Kallikreins / Q000097:blood*; D008297:Male; D009504:Neutrophils / Q000473:pathology*; D011467:Prostate / Q000378:metabolism / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen