title: Predictive value of neutrophil-to-lymphocyte ratio in diagnosis of prostate cancer among men who underwent template-guided prostate biopsy: A STROBE-compliant study.
abstract: To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) in diagnosis of prostate cancer (PCa). Data of 662 patients who underwent prostate biopsy from January 2012 to June 2016 were retrospectively reviewed. The receiver operating characteristic-derived area under the curve analyses were performed to assess the predictive accuracy. Simultaneously, Youden's index was calculated to determine the optimal NLR cutoff. Furthermore, univariate and multivariate logistic regression analyses were performed to determine the association between NLR value and PCa detection. On account of an NLR value of 2.44 was shown with the maximal Youden's index on the receiver operating characteristic curve, the cutoff value of NLR was set at 2.44. Accordingly, patients were classified into high-NLR or low-NLR group. The patients in high-NLR group might have significant higher risk to be diagnosed with PCa (HR 1.640; P = 0.031), especially in the subgroup with prostate-specific antigen (PSA) ranged from 4 to 10 ng mL (hazard ratio [HR] 4.364; P = 0.003). The high-NLR was independent of age of diagnosis, PSA, prostate volume, abnormal digital rectal examination, and hypoechoic lesion on transrectal ultrasound for positive prostate biopsy. In the so-called gray area, combination of NLR value could raise 4.6% of the accuracy of the multivariate logistic model in PCa prediction, but not in advanced PCa prediction.The patients with high-NLR value may have significant higher risk to be diagnosed with PCa, especially among the patients with PSA ranged from 4 to 10 ng mL. In this subgroup, the adding of NLR value in the multivariate model can improve the accuracy of PCa prediction in a large degree. If validated, the NLR will become a promising, accessible, inexpensive biomarker for PCa prediction.
authors.affiliation: Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China Department of General Surgery, Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, Jiangsu Province, China Department of Urology, Shanghai Tenth People's Hospital, Shanghai, China.
authors.forename: Tian-Bao
authors.initials: TB
authors.lastname: Huang
authors.forename: Shi-Yu
authors.initials: SY
authors.lastname: Mao
authors.forename: Sheng-Ming
authors.initials: SM
authors.lastname: Lu
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Yu
authors.forename: Yang
authors.initials: Y
authors.lastname: Luan
authors.forename: Xiao
authors.initials: X
authors.lastname: Gu
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.forename: Guang-Chen
authors.initials: GC
authors.lastname: Zhou
authors.forename: Xue-Fei
authors.initials: XF
authors.lastname: Ding
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D011237:Predictive Value of Tests; D011467:Prostate; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies