Application Of Systemic Immune-inflammation Index In The Diagnosis Of Prostate Cancer

Background and purpose:Prostate Cancer(PCa)is a common malignant tumor in men.At present,prostate cancer is mainly treated by surgery,endocrine therapy,radiotherapy and chemotherapy.With the continuous improvement of China’s economic level and medical technology,the number of new prostate cancer patients has increased significantly every year,and the trend is younger.Early surgical treatment is of great significance for prostate cancer,which can significantly improve the long-term survival rate.Therefore,early diagnosis is very important.Prostate Specific Antigien(PSA)is a commonly used screening method in clinical practice,but its disadvantages are very obvious.It is easy to be affected by prostatic hyperplasia,prostatitis,prostate injury,and digital rectal examination,which leads to a decrease in the diagnostic specificity of prostate cancer.In addition,with the development of molecular biology technology and immunodetection technology,some new tumor markers have been found and applied in clinical practice,which makes the understanding of prostate cancer more accurate and provides a basis for further formulating individualized diagnosis and treatment plans.Therefore,it is necessary to find new biomarkers for prostate cancer,which are not only economical and convenient,but also can improve the diagnostic accuracy of prostate cancer.There are few reports about the relationship between systemic immune-inflammation index(SII)and prostate cancer,and the indicators for calculating SII are all derived from blood routine,which is very easy to obtain.Therefore,this study aims to investigate the diagnostic value of systemic immune inflammation index in prostate cancer,and provide a new idea for the diagnosis of prostate cancer.Methods:The clinical data of 210 patients who underwent prostate biopsy in Henan University People’s Hospital from January 2020 to January 2022 were retrospectively analyzed.Patients were divided into prostate cancer group and non-prostate cancer group according to pathological results.The clinical data including age,neutrophil,lymphocyte,platelet,monocyte,PSA,Gleason score and biopsy pathological report were collected.All parameters were tested for normality,and differences were analyzed by Mann-Whitney U test.Secondly,logistic regression analysis was further improved to evaluate the independent risk factors of prostate cancer.To study the diagnostic value of SII for prostate cancer,the Receiver Operator Characteristic Curve(ROC)was used to obtain the best cut-off value of SII,sensitivity and specificity.Combined with the postoperative pathological grading of patients,the correlation between SII and postoperative pathological grading of prostate cancer patients was explored.Finally,through the study of patients with PSA in the range of 4-20 ng/ml,the diagnostic efficacy of SII in prostate cancer in this range was explored.Results:1.General data analysis: We performed the Mann-Whitney U test for each parameter in the two groups separately.Age,PSA,lymphocytes,SII,Neutrophil-To-Lymphocyte Ratio(NLR)and Monocyte-ToLymphocyte ratio(monocyte-to-lymphocyte ratio)were analyzed Ratio,MLR)between the two groups were statistically significant(P < 0.05).2.In the further improved logistic regression analysis,univariate and multivariate logistic regression analysis showed that age(P < 0.001),PSA(P=0.014)and SII(P=0.046)were independent risk factors for predicting prostate cancer.3.Using ROC receiver operating curve to analyze age,PSA,SII and other parameters,the AUC reached the level of predictive value.The AUC of SII was 0.651,the best cut-off value was 909.48,and the corresponding sensitivity and specificity were 55.8% and 71.3%,respectively.4.In the correlation study combined with SII and postoperative pathological grading,there was no significant difference in SII among GS < 7,GS=7,and GS > 7 groups(P=0.108).5.In the study within the specific PSA range(4-20 ng/ml),Mann-Whitney U test showed that age(P=0.008),PSA(P=0.016),SII(P=0.004)were significantly different,and the area under the ROC curve of SII was 0.660.SII has predictive value for prostate cancer patients within this PSA range.Conclusion:1.Systemic immune-inflammation index(SII)is significantly correlated with the risk of prostate cancer.With 909.48 as the cut-off value,patients with high SII should be actively monitored.2.There was no significant difference in SII among different pathological grades of prostate cancer patients.3.SII has predictive value for prostate cancer when PSA is between 4 and 20ng/ml.