Analysis of the predictive value of the prostate-specific antigen-to-neutrophil ratio for the diagnosis of prostate cancer

Abstract Background Currently, serum PSA is the most commonly used screening tool in clinical practice. However, PSA levels in the range of 4–10 ng/ml are considered the ‘grey zone’ of prostate cancer screening. Patients within this range need to be further evaluated using additional parameters such...

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Main Authors: Yuxuan Chen, Haisheng Yan, Yaoqin Xu, Kexin Chen, Runqin Yang, Jiali Yang, Ruian Zhu, Rui Lin, Jiang Wang, Jie Liu, Pingsheng Gao, Lei Pang, Lexin Wang
Format: Article
Language:English
Published: Springer 2025-01-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-01760-8
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author Yuxuan Chen
Haisheng Yan
Yaoqin Xu
Kexin Chen
Runqin Yang
Jiali Yang
Ruian Zhu
Rui Lin
Jiang Wang
Jie Liu
Pingsheng Gao
Lei Pang
Lexin Wang
author_facet Yuxuan Chen
Haisheng Yan
Yaoqin Xu
Kexin Chen
Runqin Yang
Jiali Yang
Ruian Zhu
Rui Lin
Jiang Wang
Jie Liu
Pingsheng Gao
Lei Pang
Lexin Wang
author_sort Yuxuan Chen
collection DOAJ
description Abstract Background Currently, serum PSA is the most commonly used screening tool in clinical practice. However, PSA levels in the range of 4–10 ng/ml are considered the ‘grey zone’ of prostate cancer screening. Patients within this range need to be further evaluated using additional parameters such as PSA ratio, PSA density, and other indices to determine the necessity of prostate biopsy (PBx). Despite this, patients in the ‘grey zone’ still have a low rate of positive biopsy results. Neutrophils have been found to be associated with tumor development and inflammation. Based on this, we combined PSA and absolute neutrophil counts to calculate the total PSA to absolute neutrophil ratio (PNR), which is higher in patients with prostate cancer and lower in those with benign conditions. PNR is elevated in prostate cancer patients compared to those with prostate enlargement. Therefore, the aim of this study is to explore the diagnostic efficacy of PNR for prostate cancer across different PSA intervals and to provide new insights into the diagnosis, treatment, and screening strategies for prostate cancer. Objective In this study, we explored the predictive value of prostate-specific antigen-to-neutrophil ratio (PNR) for the diagnosis of prostate cancer, with a view to further improving the diagnostic accuracy of prostate cancer. Methods Patients were grouped in three different divisions of PSA 4–10 ng/ml, 10–20 ng/ml, > 20 ng/ml, We grouped the patients and compared the test data such as age, PSA, PSA-density (PSAD), and prostate-specific antigen-to-neutrophil ratio (PNR) between the two groups of patients who had puncture results of prostate cancer and non-prostate cancer at the same time using Log regression test to verify the diagnostic value of PNR. Results When PSA levels are in the range of 4–10 ng/ml, an elevated PNR is an independent risk factor for prostate cancer. In this range, the diagnostic value of f/t PSA and PSAD for prostate cancer is limited. However, the use of PNR can significantly enhance the diagnostic efficacy for prostate cancer and thereby effectively reduce the incidence of unnecessary prostate biopsies.
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spelling doaj-art-8a78b3a7fb4c464db87b70f87f1a82ef2025-02-09T12:43:33ZengSpringerDiscover Oncology2730-60112025-01-0116111110.1007/s12672-025-01760-8Analysis of the predictive value of the prostate-specific antigen-to-neutrophil ratio for the diagnosis of prostate cancerYuxuan Chen0Haisheng Yan1Yaoqin Xu2Kexin Chen3Runqin Yang4Jiali Yang5Ruian Zhu6Rui Lin7Jiang Wang8Jie Liu9Pingsheng Gao10Lei Pang11Lexin Wang12Department of Urology, People’s Hospital of Ningxia Hui Autonomous RegionNingxia Medical UniversityNingxia Medical UniversityNingxia Medical UniversityNingxia Medical UniversityDepartment of Urology, People’s Hospital of Ningxia Hui Autonomous RegionWestern Institute of Digital-Intelligent MedicineSchool of Clinical Medicine, The Affiliated Hospital, Southwest Medical UniversitySchool of Clinical Medicine, The Affiliated Hospital, Southwest Medical UniversityDepartment of General Surgery, Dazhou Central HospitalDepartment of Urology, People’s Hospital of Ningxia Hui Autonomous RegionDepartment of Clinical Research Center, Dazhou Central HospitalDepartment of Urology, People’s Hospital of Ningxia Hui Autonomous RegionAbstract Background Currently, serum PSA is the most commonly used screening tool in clinical practice. However, PSA levels in the range of 4–10 ng/ml are considered the ‘grey zone’ of prostate cancer screening. Patients within this range need to be further evaluated using additional parameters such as PSA ratio, PSA density, and other indices to determine the necessity of prostate biopsy (PBx). Despite this, patients in the ‘grey zone’ still have a low rate of positive biopsy results. Neutrophils have been found to be associated with tumor development and inflammation. Based on this, we combined PSA and absolute neutrophil counts to calculate the total PSA to absolute neutrophil ratio (PNR), which is higher in patients with prostate cancer and lower in those with benign conditions. PNR is elevated in prostate cancer patients compared to those with prostate enlargement. Therefore, the aim of this study is to explore the diagnostic efficacy of PNR for prostate cancer across different PSA intervals and to provide new insights into the diagnosis, treatment, and screening strategies for prostate cancer. Objective In this study, we explored the predictive value of prostate-specific antigen-to-neutrophil ratio (PNR) for the diagnosis of prostate cancer, with a view to further improving the diagnostic accuracy of prostate cancer. Methods Patients were grouped in three different divisions of PSA 4–10 ng/ml, 10–20 ng/ml, > 20 ng/ml, We grouped the patients and compared the test data such as age, PSA, PSA-density (PSAD), and prostate-specific antigen-to-neutrophil ratio (PNR) between the two groups of patients who had puncture results of prostate cancer and non-prostate cancer at the same time using Log regression test to verify the diagnostic value of PNR. Results When PSA levels are in the range of 4–10 ng/ml, an elevated PNR is an independent risk factor for prostate cancer. In this range, the diagnostic value of f/t PSA and PSAD for prostate cancer is limited. However, the use of PNR can significantly enhance the diagnostic efficacy for prostate cancer and thereby effectively reduce the incidence of unnecessary prostate biopsies.https://doi.org/10.1007/s12672-025-01760-8Prostate cancerNeutPSAPNRProstate puncture biopsy
spellingShingle Yuxuan Chen
Haisheng Yan
Yaoqin Xu
Kexin Chen
Runqin Yang
Jiali Yang
Ruian Zhu
Rui Lin
Jiang Wang
Jie Liu
Pingsheng Gao
Lei Pang
Lexin Wang
Analysis of the predictive value of the prostate-specific antigen-to-neutrophil ratio for the diagnosis of prostate cancer
Discover Oncology
Prostate cancer
Neut
PSA
PNR
Prostate puncture biopsy
title Analysis of the predictive value of the prostate-specific antigen-to-neutrophil ratio for the diagnosis of prostate cancer
title_full Analysis of the predictive value of the prostate-specific antigen-to-neutrophil ratio for the diagnosis of prostate cancer
title_fullStr Analysis of the predictive value of the prostate-specific antigen-to-neutrophil ratio for the diagnosis of prostate cancer
title_full_unstemmed Analysis of the predictive value of the prostate-specific antigen-to-neutrophil ratio for the diagnosis of prostate cancer
title_short Analysis of the predictive value of the prostate-specific antigen-to-neutrophil ratio for the diagnosis of prostate cancer
title_sort analysis of the predictive value of the prostate specific antigen to neutrophil ratio for the diagnosis of prostate cancer
topic Prostate cancer
Neut
PSA
PNR
Prostate puncture biopsy
url https://doi.org/10.1007/s12672-025-01760-8
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