Introduction: We investigated whether the change in the neutrophil lymphocyte ratio (NLR) from the first to the last repeat prostate biopsy (ΔNLR) could be the diagnostic tool or not for prostate cancer (PCa) detection. Materials and Methods: We retrospectively evaluated medical records of men who had undergone repeat prostate biopsy. The investigated parameters were white blood cell, neutrophil, lymphocyte counts, NLR at the last prostate biopsy, ΔNLR, prostate-specific antigen (PSA), PSA density (PSAD), and PSA velocity. Exclusion criteria were the presence of cancers other than prostate origin, medication, and diseases which induce the change of NLR. Results: A total of 301 men who had undergone repeat prostate biopsy were selected for this study. After applying exclusion criteria, 223 patients were included. Of these patients, 94 were diagnosed with PCa (Group I) and 129 with no malignancy (Group II). Only a single patient had metastasis. On evaluating the area under the receiver operating characteristic curve of all study parameters, ΔNLR was the most accurate marker, followed by PSAD and then NLR measured at the last biopsy. Conclusions: ΔNLR was the most accurate marker to improve the total predictive value in repeat prostate biopsy for diagnosing PCa.

Keywords:
Prostate cancer, Neutrophil lymphocyte ratio, Prostate biopsy
1.
Catalona WJ, Richie JP, Ahmann FR, et al: Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men. J Urol 1994; 151: 1283–1290.
2.
Seo HK, Chung MK, Ryu SB, et al: Detection rate of prostate cancer according to prostate-specific antigen and digital rectal examination in Korean men: a nationwide multicenter study. Urology 2007; 70: 1109–1112.
3.
Keetch DW, Catalona WJ, Smith DS: Serial prostatic biopsies in men with persistently elevated serum prostate specific antigen values. J Urol 1994; 151: 1571–1574.
4.
Wade J, Rosario DJ, Macefield RC, et al: Psychological impact of prostate biopsy: physical symptoms, anxiety, and depression. J Clin Oncol 2013; 31: 4235–4241.
5.
Ozyalvacli G, Yesil C, Kargi E, et al: Diagnostic and prognostic importance of the neutrophil lymphocyte ratio in breast cancer. Asian Pac J Cancer Prev 2014; 15: 10363–10366.
6.
Yuksel OH, Verit A, Sahin A, et al: White blood cell counts and neutrophil to lymphocyte ratio in the diagnosis of testicular cancer: a simple secondary serum tumor marker. Int Braz J Urol 2016; 42: 53–59.
7.
Mochizuki T, Kawahara T, Takamoto D, et al: The neutrophil-to-lymphocyte ratio (NLR) predicts adrenocortical carcinoma and is correlated with the prognosis. BMC Urol 2017; 17: 49.
8.
Zhou WW, Chu YP, An GY: Significant difference of neutrophil-lymphocyte ratio between colorectal cancer, adenomatous polyp and healthy people. Eur Rev Med Pharmacol Sci 2017; 21: 5386–5391.
9.
Kawahara T, Fukui S, Sakamaki K, et al: Neutrophil-to-lymphocyte ratio predicts prostatic carcinoma in men undergoing needle biopsy. Oncotarget 2015; 6: 32169–32176.
10.
Maeda Y, Kawahara T, Kumano Y, et al: The neutrophil-to-lymphocyte ratio before repeat prostate needle biopsy for predicting prostate cancer. Urol Int 2016; 96: 123–134.
11.
Bokhorst LP, Alberts AR, Rannikko A, et al: Compliance rates with the prostate cancer research international active surveillance (PRIAS) protocol and disease reclassification in noncompliers. Eur Urol 2015; 68: 814–821.
12.
Kawahara T, Yokomizo Y, Ito Y, et al. Pretreatment neutrophil-to-lymphocyte ratio predicts the prognosis in patients with metastatic prostate cancer. BMC Cancer 2016; 16: 111.
13.
Templeton AJ, Pezaro C, Omlin A, et al: Simple prognostic score for metastatic castration-resistant prostate cancer with incorporation of neutrophil-to-lymphocyte ratio. Cancer 2014; 120: 3346–3352.
14.
Marvel D, Gabrilovich DI: Myeloid-derived suppressor cells in the tumor microenvironment: expect the unexpected. J Clin Invest 2015; 125: 3356–3364.
15.
Chi N, Tan Z, Ma K, et al: Increased circulating myeloid-derived suppressor cells correlate with cancer stages, interleukin-8 and -6 in prostate cancer. Int J Clin Exp Med 2014; 7: 3181–3192.
16.
Salman H, Ori Y, Bergman M, et al: Human prostate cancer cells induce inflammatory cytokine secretion by peripheral blood mononuclear cells. Biomed Pharmacother 2012; 66: 330–333.
17.
Suwa T, Hogg JC, English D, et al: Interleukin-6 induces demargination of intravascular neutrophils and shortens their transit in marrow. Am J Physiol Heart Circ Physiol 2000; 279:H2954–H2960.
18.
Vickers AJ, Wolters T, Savage CJ, et al: Prostate specific antigen velocity does not aid prostate cancer detection in men with prior negative biopsy. J Urol 2010; 184: 907–912.
19.
Ploussard G, Nicolaiew N, Marchand C, et al: Risk of repeat biopsy and prostate cancer detection after an initial extended -negative biopsy: longitudinal follow-up from a prospective trial. BJU Int 2013; 111: 988–996.
20.
Remzi M, Anagnostou T, Ravery V, et al: An artificial neural network to predict the outcome of repeat prostate biopsies. Urology 2003; 62: 456–460.
21.
Noguchi M, Yahara J, Koga H, et al: Necessity of repeat biopsies in men for suspected prostate cancer. Int J Urol 1999; 6: 7–12.
© 2018 S. Karger AG, Basel
2018
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.