Predictive Significance of Preoperative Neutrophil to Lymphocyte Ratio versus Platelet to Lymphocyte Ratio for Gleason Score in Prostate Cancer Patients

Abstract

Objective: Inflammation plays a critical role in the development and progression of cancer. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are easily accessible basic inflammatory parameters. In this study, we aimed to analyze the association between the NLR, PLR, and the Gleason score in prostate cancer, which is main parameter used in the prostate cancer prognosis. Materials and Methods: A total of 173 patients with prostate cancer (mean age, 63 +/- 6.2 years) who underwent radical prostatectomy were included into this retrospective study. The NLR and PLR were derived from the complete blood cell count results from the preoperative period. Patients were divided into two groups, as the low grade prostate cancer (Gleason score <= 7 [3+4]) and the high-grade prostate cancer (Gleason score <= 7 [4+3]) group. A logistic regression analysis was performed to determine the association. Results: A univariate logistic regression analysis showed that the Ln-prostate specific antigen (PSA) (1.83, 95% confidence interval [CI] [1.01, 3.3] p=0.04), Ln-lymphocyte (0.38, 95% CI [0.15, 0.94] p=0.03), and Ln-NLR (1.9, 95% CI 1.9 [1.13, 3.38] p=0.01) levels were significantly associated with the high-grade Gleason score. However, the Ln-PLR levels revealed the association with marginal statistical significance (2.06, 95 % CI [0.95, 4.4] p=0.06). In multiple analyses, after adjusting the analysis for age, Ln-NLR (1.96, 95% CI [1.12, 3.42] p=0.01) and Ln-lymphocyte levels (0.38, 95% CI [0.15, 0.97] p=0.04) were still statistically significantly associated with high-grade prostate cancer. Conclusion: Higher NLR levels were significantly associated with high-grade prostate cancer. However, PLR levels were not a significant predictor of higher Gleason scores.