TITLE:
Mean Platelet Volume as an Inflammation Marker, Possible Biomarker of Tumor Detection in Prostate Biopsy
AUTHORS:
Caner Ediz, Serkan Akan, Omer Yilmaz, Muhammed Cihan Temel, Ozlem Koksal
KEYWORDS:
Mean Platelet Volume, Neutrophil Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, Prostate Biopsy, Prostate Cancer, Atypical Small Acinar Proliferation
JOURNAL NAME:
Open Journal of Urology,
Vol.9 No.2,
February
13,
2019
ABSTRACT: Background: In the diagnosis of prostatic diseases, the need for markers other
than prostate specific antigen (PSA) has been increasing in recent years.
So, we aimed to determine the predictive value, the neutrophil lymphocyte
ratio, platelet-to-lymphocyte ratio and mean platelet volume before prostate
biopsy in predicting the results of pathology. Transrectal ultrasound-guided
biopsy of the prostate was performed because of high PSA values and compared
values of these parameters to predict of pathology results. Methods: 2715 patients who underwent 10 - 12 quadrant transrectal ultrasound-guided
prostate biopsies between January 2008 and January 2018 have been evaluated
retrospectively. Patients were divided into groups according to the biopsy
pathology results by benign (group 1), atypical small acinar proliferation
(ASAP) (group 2) and prostate cancer (group 3). A total of 204 patients who
were benign prostate hyperplasia in 71 patients (34.8%), atypical small acinar
proliferation in 80 (39.21%) and prostate adenocarcinoma (PCa) in 53 patients
(25.98%) were included in the study by systematic sampling. Before the
biopsy total PSA (tPSA), free PSA (fPSA), rate of percentage of free to total
prostate specific antigen (f/tPSA) rate, PSA density (PSA-D), white blood cell
(WBC) count, blood neutrophil count (NC), blood lymphocyte count (LC),
neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV), platelet
count (PLT) and platelet-to-lymphocyte ratio (PLR) were measured and
compared in all groups. Differences in continuous variables were assessed
using the ANOVA. Logistic regression was used to analyze the linear relationship
between predictive variables and pathology results. P Results: NLR and PLR values were lower
in group 1 than group 2 and were found statistically significant between in
group 1 and group 2 (p: 0.03 and p: 0.02, respectively). MPV value was found
1.7 times higher in patients who were diagnosed with ASAP pathology than those with benign pathologies. Although there was statistically significant increase
in MPV values in logistic regression results, no statistically significant
diagnostic value was found. In addition MPV value was found 0.5 times
higher in patients who were diagnosed patients with ASAP than prostate
cancer group. ROC analysis showed that the optimal threshold was 7.65 femtoliter
(sensitivity: 51%; specificity: 30%) and was found to be a statistically
significant diagnostic value to distinguish groups 2 and 3. The lowest value of
MPV was found in group 3. Conclusions: In cases where the PSA value is
insufficient in predicting the pathology result, the effect of NLR, PLR and
MPV on differential diagnosis can be kept in mind. While NLR and PLR are
more useful in the diagnosis of ASAP, MPV is more effective in the diagnosis
of malignancy.