Systemic immune-inflammation index, but not neutrophil-to-lymphocyte ratio, is a predictor for detecting clinically significant prostate cancer at first biopsy

To determine whether systemic immune-inflammation index (SIII) and neutrophil-to-lymphocyte ratio (NLR) could be predictive factors for detecting clinically significant prostate cancers at first biopsy in men with a PSA level of 3.0–10.0 ng/ml or abnormal digital rectal examination (DRE) findings. Clinical records of 1,073 men with PSA of 3.0–10.0 ng/ml or abnormal DRE findings who underwent first prostate biopsy were reviewed. Before prostate biopsy, baseline evaluations were performed, including medical history, DRE, urinalysis, serum PSA, and blood tests such as CBC and testosterone. Clinically significant prostate cancer, NLR and SIII were defined as Gleason grade group of 2 or higher, absolute neutrophil counts/absolute lymphocyte counts, and absolute neutrophil counts x platelet counts/absolute lymphocyte counts, respectively. The overall detection rate of prostate cancer was 22.9% (246/1073). Among these 246 men with prostate cancer, clinically significant cancers were detected in 121 (49.2%) men. No statistically significant differences in NLR were noted for those with benign diseases, those with clinically insignificant cancer, and those with clinically significant cancer. The SIII for men with clinically significant cancers was significantly lower than that for men with benign diseases or clinically insignificant cancers. The multivariate logistic regression analysis showed that age, diabetes mellitus, serum PSA level, prostate volume, and SIII were independent predictors of clinically significant cancers. SIII, but not NLR, is a predictor for detecting clinically significant prostate cancer in patients with a PSA level of 3.0–10.0 ng/ml or abnormal DRE findings at first biopsy.