The Associations Of Hs-CRP,NLR And PLR With Bone Metastasis In Patients Newly Diagnosed With Prostate Cancer

Part I The associations of hs-CRP,NLR and PLR with bone metastasis in patients newly diagnosed with prostate cancerObjective: To assess the associations of high sensitive C-reactive protein(hs-CRP),neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)with bone metastasis in patients newly diagnosed with prostate cancer.Methods: A total of 294 consecutive patients with prostate cancer newly diagnosed by prostate biopsy from January 2010 to December 2015 were enrolled in this study.The difference of hs-CRP,NLR and PLR between patients with bone metastasis and without bone metastasis was analyzed by Mann-Whitney U test.Logistic regression was used to evaluate independent predictors for bone metastasis.Areas under operating characteristic curves(AUC)were used to compare the predictive value of hs-CRP,PLR,prostate specific antigen(PSA)and prostate specific antigen density(PSAD).Results:The median(interquartile range)of hs-CRP was 6.90mg/L(1.95-13.74 mg/L)in patients with bone metastasis which is higher than 1.43mg/L(0.70-4.32 mg/L)in those without bone metastasis(P<0.05).The median of PLR was 137.40(106.80~179.71)in patients with bone metastasis which is higher than 116.67(86.90~161.40)in those without bone metastasis(P<0.05).The median of NLR was 2.62(2.04~3.70)in patients with bone metastasis which is higher than 2.37(1.73~3.28)in those without bone metastasis,while significant differences was not found between the two groups(P>0.05).The level of PSA,Gleason score and clinical stage were also significant different between the two groups(P<0.05).According to the logistic regression analysis,hs-CRP(OR=1.142,95%CI: 1.073~1.216,P<0.05),PSA(OR=1.012,95%CI: 1.001~1.022,P<0.05)and Gleason score(OR=2.735,95%CI: 1.227~5.895,P<0.05)were significant independent predictors for bone metastasis.AUC of hs-CRP was 0.720 and the cutoff value was 3.1mg/L.Conclusions : High hs-CRP is significantly correlated with bone metastasis.Measurement of hs-CRP plays an important role in predicting bone metastasis among patients with newly diagnosed prostate cancer.Part II The associations ofhs-CRP,NLR and PLRwith oligometastasis in patients newly diagnosed with prostate cancerObjective To assess the associations of high sensitive C-reactive protein(hs-CRP),neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)with oligometastasis in patients newly diagnosed with prostate cancer.Methods A total of 66 consecutive patients diagnosed with metastatic prostate cancer by prostate biopsy and bone scan from January 2010 to March 2016 were enrolled in this study.Patients were divided into oligometastasis group(not more than five bone metastasis)and multiple metastasis group(more than five bone metastasis).The differences of hs-CRP,NLR and PLR between oligometastasis group and multiple metastasis group were analyzed by Mann-Whitney U test.Logistic regression was used to evaluate the effect of factors such as NLR and PLR,prostate specific antigen(PSA)and Gleason score on bone oligometastasis.Areas under operating characteristic curves(AUC)were used to compare the predictive value of NLR and PLR.Results The median of NLR was 2.14(1.66~3.01)in oligometastasis group,which is lower than 3.11(2.28~4.33)in multiple metastasis group(P<0.05).The median of PLR was 119.47(98.91~152.08)in oligometastasis group,which is lower than 171.76(130.51~211.02)in multiple metastasis group(P<0.05).While the level of hs-CRP prostate specific antigen(PSA),Gleason score and clinical stagehad no statistically significant difference between the two groups(P>0.05).According to the logistic regression analysis,NLR≤2.59(OR=3.056,95%CI: 1.116-8.365,P<0.05)and PLR≤146.69(OR=3.538,95%CI: 1.277-9.805,P<0.05)were significant predictors for oligometastasis.AUC of NLR and PLR were 0.713 and 0.710 respectively.Conclusions Lower NLR and lower PLR are significantly correlated with prostate cancer oligometastasis.Measurement of NLR and PLR plays an important role in diagnosis of oligometastasis.