The predictive value of immune cells in prostate cancer

This review examined whether the neutrophil-to-lymphocyte ratio (NLR) was useful in predicting the prognosis of prostate cancer. Researchers reported a strong link between the NLR and overall survival and cancer recurrence.

Neutrophils are cells that are involved in inflammation (reaction to injury or infection). Lymphocytes are cells involved in the immune response. The neutrophil-to-lymphocyte ratio (NLR) can be easily calculated from routine blood tests. An elevated NLR has previously been associated with poor clinical outcomes in various cancers. This is likely due to inflammation playing an essential role in cancer development and progression.

The NLR has also been linked to prostate cancer. Some studies are suggesting that an elevated NLR can predict disease progression in prostate cancer. However, evidence for this is mixed, with some studies reporting no association between NLR and prostate cancer. A growing number of men are living with prostate cancer due to advances in treatment and early detection. Identifying factors that can reliably predict long-term prognosis is, therefore, increasingly important.

The aim of this study was to analyze the predictive value of NLR in prostate cancer.

A total of 9,418 men with prostate cancer from 18 separate studies were included in the analysis. 8 trials evaluated the association between the NLR and localized (confined) prostate cancer. 10 trials evaluated the association between the NLR and locally advanced (tumor protruding into nearby tissue) or metastatic (cancer spreading to distant organs) prostate cancer no longer responding to standard hormone therapy. NLR values were measured before treatment. Treatment outcomes were followed for an average of 18 months.

Overall survival (time from treatment until death from any cause) was poorer if the NLR was elevated. The NLR did not significantly affect overall survival in men with localized prostate cancer. However, men with more advanced cancer and a high NLR were 51% less likely to survive the study follow-up compared to men with low NLR.

Overall, men with a high NLR before treatment were 36% more likely to experience cancer recurrence after treatment. The time to cancer recurrence was also significantly shorter when NLR was elevated, regardless of localized or advanced disease.

Gleason score (indicating the aggressiveness of cancer cells) or tumor stage did not affect NLR results. However, lymph node involvement (local lymph nodes containing cancer cells) increased the effect of the NLR on treatment outcomes.

Researchers concluded that a high NLR is an independent risk factor for cancer recurrence in men with prostate cancer, and for overall survival in men with locally advanced or metastatic prostate cancer..