Importance of netrophil-lymphocyte ratio and platelet-lymphocte ratio in the diagnosis of prostate cancer

Objective: Prostate cancer (PCa) is one of the solid organ malignancies most seen in men in the world and in our country. Genetic and environmental factors have a role in the etiopathogenesis of PCa. The role of the inflammatory process is generally accepted in the etiology of PCa, but its pathogenesis is discussed. Although there are many studies on this inflammation and cancer process. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), which have gained popularity in the oncological literature recently. In this thesis, we investigated the relationship of NLR and PLR with PCa in patients who underwent transrectal ultrasonography (TRUS) guided prostate biopsy in our clinic with suspicion of PCa. Material and Method: Between January 2015 and January 2020, 878 patients undergone TRUS guided prostate biopsy in our researh clinic were included in the study. It was divided into four groups according to Prostate Spesific Antigen (PSA) levels: below 4 ng / ml (Group 1) , 4-10 ng / ml (Group 2), 10-20 ng / ml (Group 3), above 20 ng / ml (Group 4). The relationship of NLR in these groups with PCa and Prostatitis was examined. Results: A total of 878 patients, 39 (4.4%) in group 1, 561 (63.9%) in group 2, 169 (19.2%) in group 3, and 109 (12.4%) in group 4 were included in our study. When all patients were evaluated, the mean age was found to be 64.68 ± 7.26 years. When we classified the patients in the study according to the pathological diagnosis, it was seen that 530 (60.4%) of 878 patients were reported as BPH, 234 (26.7%) as PCa and 114 (13.0%) as prostatitis. When these results were evaluated, no significant relationship was found between NLR and PLR in BPH, PCa and prostatitis subgroups of Group 1 patients. On the other hand, a statistically significant difference was found between PSA density, NLR and PLR in Group 2 (p <0.05). While there was no significant relationship in PLR in Group 3, a statistically significant relationship was found in NLR. In Group 4, NLR was observed as 3.24 ± 1.82 in PCa, 3.35 ± 0.81 in Prostatitis and 2.57 ± 1.26 in BPH. Conclusion: In our study, the role of NLR in the diagnosis of prostate cancer was investigated in patients who underwent TRUS-guided prostate biopsy. There was a statistically significant relationship between NLR, PSA density and gleason score in patients diagnosed with PCa. It was concluded that the predictive value of NLR was high when used with PSA density in the diagnosis of PCa in patients with a PSA level of 4-10 ng / ml. In addition, in our study, NLR has been shown to be a prognostic factor in patients with a PSA level higher than 4ng / ml, but it was found to be insufficient for predicting prognosis in tumors detected at an early stage. Key words: Diagnosis of prostate cancer, Prostate biopsy, Neutrophil / lymphocyte ratio