title: 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.
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.|Departments of Urology and Renal Transportation, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawahara
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors.forename: Sachi
authors.initials: S
authors.lastname: Fukui
authors.affiliation: Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sakamaki
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Kobayashi
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Izumi
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Yokomizo
authors.affiliation: Departments of Urology and Renal Transportation, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Miyoshi
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Makiyama
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Nakaigawa
authors.affiliation: Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Takeharu
authors.initials: T
authors.lastname: Yamanaka
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yao
authors.affiliation: Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyamoto
authors.affiliation: Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.|Departments of Urology and Renal Transportation, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Hiroji
authors.initials: H
authors.lastname: Uemura
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000276:immunology* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D006801:Humans; D007610:Kallikreins / Q000097:blood; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000276:immunology*; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000276:immunology* / Q000473:pathology*
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Clinical Section; biomarker; neutrophil-to-lymphocyte ratio; prostate cancer; prostate needle biopsy