This article was originally published here
J Pers Med. 2021 November 19; 11 (11): 1231. doi: 10.3390 / jpm11111231.
The aim of this study was to assess the predictive value of pre-biopsy blood markers in patients undergoing fusion biopsy for magnetic resonance imaging (MRI) of the suspected prostate. We identified 365 consecutive patients who underwent a targeted and systematic prostate biopsy by MRI for an MRI noted Prostate Imaging-Reporting and Data System Version (PI-RADS) ≥ 3. We evaluated the neutrophils / lymphocytes ratio (NLR) , Derived Neutrophil / Lymphocyte Ratio (dNLR), Platelet / Lymphocyte Ratio (PLR), Systemic Immune Inflammation Index (SII), Lymphocyte / Monocyte Ratio (LMR), Ritis Ratio, Modified Glasgow Prognostic Score (mGPS) and prognostic nutritional index (PNI). Univariate and multivariate logistic models were used to analyze the association of biomarkers with biopsy results. The clinical benefits of biomarkers involved in clinical decision making were evaluated using decision curve analysis (DCA). A total of 69% and 58% of patients were diagnosed with prostate cancer and Gleason grade (GG) ≥ 2, respectively. In multivariate analysis, only a high dNLR (odds ratio (OR) 2.61, 95% confidence interval (CI) 1.23-5.56, p = 0.02) and low NIBP (OR 0.48, 95% CI 0.26-0.88, p = 0.02) remained independent predictors for GG 2. Logistic regression models with biomarkers achieved AUCs of 0.824 to 0.849 for GG ≥ 2. Addition of dNLR and PNI did not improve net benefit of a standard clinical model. Finally, we have created the nomogram which can help guide biopsy avoidance in patients with suspicious MRI. In patients with PI-RADS ≥ 3 lesions undergoing systematic targeted biopsy by MRI, high dNLR and low PNI have been associated with unfavorable biopsy results. Pre-biopsy blood biomarkers, however, did not significantly improve discriminating power and failed to add clinical benefit beyond standard clinical factors.
PMID: 34834583 | DOI: 10.3390 / jpm11111231