Predictive Value of Neutrophil to Lymphocyte Ratio in the Diagnosis of Significant Prostate Cancer at Initial Biopsy: A Comparison with Free Percent Prostate Specific Antigen, Prostate Specific Antigen Density and Primary Circulating Prostate Cells.

An elevated serum PSA is the only biomarker routinely used in screening for prostate cancer to indicate a prostate biopsy. However, it is not specific for prostate cancer and the neutrophil/lymphocyte ratio has been suggested as an alternative. We present a prospective study of men with an elevated PSA and compare the neutrophil/lymphocyte ratio, free percent PSA, PSA density and the presence of circulating prostate cells to detect clinically significant prostate cancer at first biopsy.

Prospective study of consecutive men with a PSA 4-10 ng/ml referred for initial prostate biopsy, the results were compared with the neutrophil/lymphocyte ratio, free percent PSA and PSA density. Circulating prostate cells (CPCs) were detected using immunocytochemistry. The blood sample was taken immediately before the prostate biopsy.

1,223 men participated, 38% (467) of whom had prostate cancer detected, of these 322 were clinically significant. The area under the curves were for neutrophil/lymphocyte ratio, free percent PSA, PSA density and CPC detection were 0.570, 0.785, 0,620 and 0.844 respectively. Sensitivity/specificity were 0.388/0.685, 0.419/0.897, 0.598/0.624 and 0.966/0.786 respectively. The neutrophil/lymphocyte ratio did not differentiate between benign and malignant disease.

The neutrophil/lymphocyte ratio did not discriminate between benign and malignant prostatic disease in patients with a PSA between 4-10ng/ml.

Asian Pacific journal of cancer prevention : APJCP. 2019 Nov 01*** epublish ***

Nigel P Murray, Cynthia Fuentealba, Eduardo Reyes, Marco Antonio Lopez, Anibal Salazar, Simona Minzer, Lorena Munoz, Shenda Orrego, Eghon Guzman, Lucas Arzeno

Consultant in Hematology, Department of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, Santiago, Chile., Consultant Urologist, Department of Urology, Hospital de Carabineros de Chile, Simón Bolívar, Ñuñoa, Santiago, Chile., Consultant Urologist, Department of Urology, Hospital DIPRECA, Vital Apoquindo 1200, Las Condes, Santiago, Chile., Physican General Medicine, Department of Medicine, Hospital de Carabineros de Chile, Simón Bolívar, Ñuñoa, Santiago, Chile., Consultant Internal Medicine, Department of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, Santiago, Chile., Tutor, Faculty of Medicine, University Mayor, San Pio X 2245, Providencia, Santiago, Chile.