Correlation of neutrophil-lymphocyte ratio and the clinical progression of benign prostatic hyperplasia

Objective To evaluate the relationship between neutrophil-lymphocyte ratio(NLR) and benign prostatic hyperplasia(BPH), and to explore the effect of NLR on clinical progression in patients with BPH. Methods A retrospective analysis of clinical data of 274 patients with BPH who admitted to the department of urology, the first affiliated hospital of Xiamen university from January 1, 2015 to December 31, 2017 was performed. Statistical methods were used to analyze the correlation between NLR and prostate volume(PV), international prostate symptom score(IPSS), maximum urinary flow rate(Qmax), and prostate-specific antigen(PSA). According to age, PV, IPSS, Qmax, PSA, the patients were divided into high-risk group and low-risk group, and NLR was compared between these groups. The receiver operating characteristic(ROC) curve was used to analyze the capability of NLR in identifying patients at a high-risk of progression. Then, according to whether the postoperative pathology contains inflammatory cell infiltration, it was divided into non-invasion group and infiltration group, and statistical analysis was performed between the infiltration group. Results NLR was positively correlated with PV and IPSS(r=0.126, P=0.038; r=0.139, P=0.021), and negatively correlated with Qmax(r=-0.169, P=0.005), but not correlated with PSA(P>0.05). When the patients were divided into group based on PV and Qmax, the high-risk group had a significantly higher NLR than the low-risk group(t=2.338, P=0.020; t=2.763, P=0.006). When the patients were divided into group based on age, IPSS and PSA, there was no significant difference in NLR between high-risk group and low-risk group(P>0.05). The ROC curve analysis showed that NLR had a cut-off value of 1.71, a sensitivity of 71.0%, and a specificity of 49.1% in predicting high-risk PV, while it had a cut-off value of 1.49, a sensitivity of 79.4%, and a specificity of 30.3% in predicting high-risk Qmax.The infiltration group had a significantly higher NLR than the non-invasion group(t=2.156, P=0.032), and the comparison between the infiltration group was also statistically significant(F=9.959, P<0.001). Conclusions NLR is positively correlated with the progression of BPH, and is one of the important factors in the clinical progress of BPH. It can provide serious information of patients and can be used as one of the indicators for follow.up. Key words: Prostatic Hyperplasia; neutrophil-lymphocyte ratio; Prostate-Specific Antigen