J Clin Lab Anal. 2018;32:e22277. wileyonlinelibrary.com/journal/jcla
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© 2017 Wiley Periodicals, Inc.
Clinical implications of pretreatment inflammatory biomarkers
as independent prognostic indicators in prostate cancer
| Ying Ju
| Fuyan Han
| Xiya Sun
| Fang Wang
Department of Clinical Laboratory, The
Second Hospital of Shandong University,
Jinan, Shandong, China
Department of Clinical Laboratory, Shandong
University, Jinan, Shandong, China
Zhaohui Sun, Department of Clinical
Laboratory, The Second Hospital of Shandong
University, Jinan, Shandong, China.
National Natural Science Foundation of China,
Science Foundation of Shandong Province,
Objectives: Research on the relationship between inflammatory biomarkers and
malignant tumors has become a hotspot. Many studies have demonstrated that
neutrophil- lymphocyte ratio (NLR), platelet- lymphocyte ratio (PLR), and red blood cell
distribution width (RDW) could act as independent prognostic indicators for several
solid tumors. This study aimed to evaluate the clinical implications of pretreatment
inflammatory biomarkers, including NLR, PLR, and RDW as independent prognostic
indicators in prostate cancer (PCa).
Methods: A total of 226 PCa patients whowerediagnosedatour institution from
2011 to 2016 were analyzed retrospectively. We comparedtheclinicopathological
features, survival curves, and prognosis of the PCa patients between the high and low
groups according to the cutoffs of NLR, PLR, and RDW.
Results: The pretreatment NLR, PLR, and RDW values were significantly higher in the
patients with PCa than those in the controls (P<.05).IncreasedNLRandPLRvalues
scores, cell proliferation antigen 67 (Ki-67) indexes, and prostate-specific antigen
free survival (DFS) (P=.017). In addition, a higher PLR only showed a significantly
worse DFS (P=.040). Pretreatment NLR was an independent prognostic indicator of
Conclusions: The pretreatment NLR and PLR might be beneficial to predict the pro-
gression and prognosis of PCa. Furthermore, NLR was more effective than PLR acting
as an independent prognostic indicator for PCa.
inflammatory biomarkers, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognostic
indicators, prostate cancer, red blood cell distribution width
1 | INTRODUCTION
Prostate cancer (PCa) is the most common urological malignant tu-
mors and the second leading cause of cancer- related death in males
after lung cancer.
As a result of aging population, alteredlifestyle,
and increased detection level, PCa continuously increases in China.
and imaging modalities and can receive promising outcomes through
the standard treatment, such as radical prostatectomy or radiother-
apy. However, a large amount of PCa patients still present at advanced
stage. Because cancer cells have the tendency of distant metastasis,
especially bones metastasis, PCa can have detrimental effect on pa-
Therefore, efficient indicators are urgently required to pre-
dict the progression and prognosis of PCa, thus to assess risk, choose
reasonable treatment, and make an appropriate surveillance method.
The inflammatory response plays a significant role in the initiation and