Prostate:淋巴细胞与单核细胞比例可预测临床显著性前列腺癌

2021-10-04 AlexYang MedSci原创

确定了淋巴细胞/单核细胞比例(LMR)和嗜酸性粒细胞/淋巴细胞比例(ELR)对CSPC的预测作用。

随着人们寿命的延长和癌症筛查的普及,越来越多的男性在前列腺特异性抗原(PSA)升高或数字直肠检查(DRE)发现异常的情况下进行前列腺活检。尽管经直肠超声引导下的前列腺活检(TRUS-Bx)是目前检测前列腺癌的参考标准,但它与临床非显著性前列腺癌的过度诊断,以及临床显著性前列腺癌的诊断不足有关,还与更高的发病率有关。主要原因是PSA的阳性预测值低,对癌症不具特异性。

炎症在致癌和癌症进展的不同阶段起着关键作用。之前一些研究显示,全身性炎症标志物在临床显著性前列腺癌(CSPCs)中的预测作用存在矛盾

近期,来自韩国的研究人员确定了淋巴细胞/单核细胞比例(LMR)和嗜酸性粒细胞/淋巴细胞比例(ELR)对CSPC的预测作用

研究人员分析了1740名男性的临床和病理数据,他们均接受了12芯TRUS-Bx检查。根据检查前的全血细胞计数计算LMR和ELR。结果发现,TRUS-Bx检查前血清前列腺特异性抗原(PSA)水平和前列腺体积的中位数(四分位数范围)分别为7.59(5.02-13.12)ng/ml和38.2(29.0-52.9)ml。分别有1179名(67.8%)、180名(10.3%)和381名(21.9%)患者检测到良性前列腺病变、临床不显著前列腺癌(CIPCs)和CSPCs。与良性病变或CIPCs患者相比,CSPCs患者年龄较大,糖尿病或高血压患病率较高,数字直肠检查异常率较高,血清PSA水平较高,血清睾酮水平较低,以及LMR较低。然而,三者(良性病变、CIPCs和CSPCs)之间的ELR没有差异。在所有患者中,多变量回归分析显示,与ELR相比,较低的LMR是CSPCs的一个独立预测因素。在前列腺体积≥39.3ml 的男性亚组中,与ELR相比,较低的LMR是CSPCs的独立预测因素。在前列腺体积小于39.3ml 的男性亚组中,LMR低的男性患CSPCs的概率高,但无统计学显著意义。

良性疾病,临床显著性癌症和临床非显著性癌症患者的研究变量比较

综上所述,与ELR相比,LMR具有独立的预测作用。LMR的预测作用对前列腺体积较大的男性更有意义

原始出处:

Min Chul Cho , Sangjun Yoo , Min Soo Choo et al. Lymphocyte-to-monocyte ratio is a predictor of clinically significant prostate cancer at prostate biopsy. Prostate. Sep 2021

 

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    2021-10-06 lsndxfj
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    2021-10-06 sunylz

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