The predictive impact of hematological inflammatory markers in detecting prostate cancer in patients with PI‐RADS 3 lesions on multiparametric magnetic resonance imaging

Abstract

AbstractBackgroundThe diagnostic accuracy of suspicious lesions that are classified as PI‐RADS 3 in multiparametric prostate magnetic‐resonance imaging (mpMRI) is controversial. This study aims to assess the predictive capacity of hematological inflammatory markers such as neutrophil‐lymphocyte ratio (NLR), pan‐immune‐inflammation value (PIV), and systemic immune‐response index (SIRI) in detecting prostate cancer in PI‐RADS 3 lesions.Methods276 patients who underwent mpMRI and subsequent prostate biopsy after PI‐RADS 3 lesion detection were included in the study. According to the biopsy results, the patients were distributed to two groups as prostate cancer (PCa) and no cancer (non‐PCa). Data concerning age, PSA, prostate volume, PSA density, PI‐RADS 3 lesion size, prostate biopsy results, monocyte counts (109/L), lymphocyte counts (109/L), platelet counts (109/L), neutrophils count (109/L) were recorded from the complete blood count. From these data; PIV value is obtained by monocyte × neutrophil × platelet/lymphocyte, NLR by neutrophil/lymphocyte, and SIRI by monocyte number × NLR.ResultsSignificant variations in neutrophil, lymphocyte, and monocyte levels between PCa and non‐PCa patient groups were detected (p = 0.009, p = 0.001, p = 0.005 respectively, p < 0.05). NLR, PIV, and SIRI exhibited significant differences, with higher values in PCa patients (p = 0.004, p = 0.001, p < 0.001 respectively, p < 0.05). The area under curve of SIRI was 0.729, with a cut‐off value of 1.20 and with a sensitivity 57.70%, and a specificity of 68.70%.ConclusionSIRI outperformed NLR and PIV in detecting PCa in PI‐RADS 3 lesions, showcasing its potential as a valuable biomarker. Implementation of this parameter to possible future nomograms has the potential to individualize and risk‐stratify the patients in prostate biopsy decision.