Predictive value of neutrophil-to-lymphocyte ratio for clinically significant prostate cancer

Purpose: The neutrophil-to-lymphocyte ratio (NLR), one of the inflammatory markers, can be calculated simply from peripheral blood samples. In this study, the role of NLR in predicting significant prostate cancer (sPC) before prostate biopsy was investigated. Materials and methods: Patients who underwent prostate biopsy between 2017 and 2022 at the National Taiwan University Hospital were enrolled prospectively. NLR was calculated before the biopsy. sPC was defined as an unfavorable-intermediate or higher risk of the National Comprehensive Cancer Network risk classification. Results: Among 484 enrolled patients, 164 sPC (33.9%) and 320 benign/insignificant prostate cancer (isPC; 66.1%) patients were diagnosed. The sPC group was older and had a higher prostate-specific antigen (PSA), smaller prostate volume, higher PSA density, more advanced clinical T stage, and more family history of prostate cancer than the benign/isPC group. There was no difference in neutrophil count ( P = 0.929), lymphocyte count ( P = 0.927), or NLR ( P = 0.931) between groups. NLR failed to predict sPC in univariable (odds ratio, 1.02; 95% confidence interval [CI], 0.93–1.12; P = 0.7) and multivariable (odds ratio, 0.94; 95% CI, 0.79–1.12; P = 0.506) logistic regression models, respectively. The area under the curve of the receiver operating characteristic curve in the model consisted of age, PSA, prostate volume, T stage, and family history of prostate cancer was 0.882 (95% CI, 0.849–0.914). There was no statistical difference when the model included NLR ( P = 0.625). Conclusion: NLR did not differ between sPC and benign/isPC groups. NLR cannot predict sPC successfully before prostate biopsy.