The Clinical Value Of Neutrophil To Lymphocytes Ratio In The Diagnosis Of Prostate Cancer And Its Relationship With Risk Grade

BackgroundProstate cancer(PCa)is a major health concern for the male population.A steady increase in the incidence rate was observed from 1975 to the early 1990 s owing to the widespread application of DRE and PSA testing for PCa screening.The PSA test was a landmark development in the early diagnosis of prostate cancer.But benign prostatic hyperplasia,prostatitis and prostate massage can also lead to increased PSA.Recently,it has been found that inflammation plays an important role in tumor progression.Neutrophil to lymphocyte ratio(NLR)is the most commonly used.NLR provides a new idea for the diagnosis and risk classification of PCa.ObjectiveObjective to study the clinical value of neutrophil lymphocyte ratio(NLR)alone or in combination with prostate specific antigen(PSA)and age in the diagnosis of prostate cancer;The relationship between NLR and risk grade of prostate cancer.MethodsFrom June 2016 to June 2020,1205 patients who came to the Department of Urology at the Third Affiliated Hospital of Xinxiang Medical College and the First Affiliated Hospital of Xinxiang Medical College were collected.The patients were divided into control group(n=1060)and prostate cancer group(n =145).The general clinical data of the two groups were compared.Univariate and multivariate logistic regression analysis was used to analyze the risk factors of prostate cancer,and the predictive model equation was established.The risk factors of prostate cancer were evaluated by receiver operating curve(ROC),and the clinical value of prostate cancer was evaluated.NLR levels were compared among different risk grades of prostate cancer.ResultsThe age,prostate specific antigen,fibrinogen(FIB),NLR,monocyte-lymphocyte ratio(MLR)and platelet-lymphocyte ratio(PLR)of the prostate cancer group were higher than those of the control group,while the lymphocyte count was lower In the control group,there were statistical differences(P<0.05);Age,PSA and NLR are independent risk factors for prostate cancer [OR(95%CI)=1.140(1.083～1.251),1.084(1.042～2.013),1.435(1.108～2.513),all P<0.05];The cut-off value for age diagnosis of prostate cancer is 53.48years(AUC=0.614,95% CI:0.587～0.652,),the cut-off value of PSA for diagnosis of prostate cancer is 5.47(AUC=0.736,95% CI :0.736～0.751),NLR diagnosis The cut-off value for prostate cancer is 2.14(AUC = 0.754,95% CI: 0.732～0.781);Joint detection established ROC curve,AUC was 0.905,sensitivity and specificity were 82.5% and 80.7%,and the model equation Logit(P)=-5.417+0.815×(NLR)+0.074×(PSA)+0.026×(Age),the best cutoff value is 0.35;The NLR levels of the low,intermediate and high-risk groups were 2.05±0.26,2.36±0.34,and 2.75±0.61,respectively,and there were statistical differences among the groups(F=32.021,P<0.001).Conclusions1.NLR is an independent risk factor for prostate cancer2.The clinical value of NLR combined with PSA and age in the diagnosis of prostate cancer is better than that of single risk factor3.NLR increased with the increase of risk grade of prostate cancer...