Table 2. The diagnostic and prognostic value of NLR in PCa.
| Inflammation-related indicators | Study design | Year | Study participants (number) | Effects/results | Major study limitations | References |
|---|---|---|---|---|---|---|
| NLR | Clinical trial | 2021 | Patients with PSA 4–10 ng/mL (n=201) | NLR could be a useful pre-PBx predictor of PCa | Retrospective cohort study, small sample size, not comparison the different stages of PCa | (14) |
| NLR | Clinical trial | 2017 | PCa patients (n=161) | Higher NLR was significantly associated with GS ≥7 PCa in comparison with GS ≤6 PCa | Retrospective nature, single center | (15) |
| NLR | Clinical trial | 2021 | PCa patients (n=571) | NLR can predict GS upgrading in patients scheduled for radical prostatectomy for PCa | Retrospective design, single tertiary center, mid- and long-term oncologic results are not indicated | (16) |
| NLR | Clinical trial | 2019 | Men undergoing an initial TRUS prostate biopsy (n=1,223) | The neutrophil/lymphocyte ratio did not discriminate between benign and malignant prostatic disease in patients with a PSA between 4–10 ng/mL | Not available | (17) |
| NLR | Clinical trial | 2019 | PCa patients (n=78) | Inflammatory markers can be predictive factors in the diagnosis of PCa | Single center | (18) |
| NLR | Clinical trial | 2021 | Patients underwent robotic transperineal prostate biopsy (n=652) | There was no statistically significant difference of NLR between the benign and PCa group | Retrospective study | (19) |
| NLR | Meta-analysis | 2016 | 15 cohorts with 16,266 patients | Elevated NLR predict poor OS and PFS/RFS in patients with PCa | Not available | (20) |
| NLR | Review and Meta-analysis | 2016 | 18,092 cases from 22 related studies | Elevated NLR predicts lower prediction of the PSARS after chemotherapy and poor survival outcomes in PCa | Not available | (21) |
| NLR | Review and Meta-analysis | 2016 | 9,418 patients from 18 studies | NLR could predict the prognosis for patients with locally advanced or castration-resistant PCa | Not available | (22) |
| NLR | Clinical trial | 2016 | PCa patients (n=2,301) | NLR is an independent prognostic factor for OS and CSS after a RP | Not available | (23) |
| NLR | Clinical trial | 2016 | Patients underwent RP (n=1,481) | High NLR was significantly related to unfavorable clinicopathological outcomes and worse BCR-free survival | Retrospective study, cohort was relatively small | (24) |
| NLR | Clinical trial | 2017 | PCa patients (n=2,302) | NLR is an independent factor for biochemical recurrence and overall survival in PCa patients | Retrospective review | (25) |
| NLR | Clinical trial | 2016 | PCa patients (n=73) | No association between NLR and biochemical failure after prostatectomy | Retrospective study, limited sample size | (26) |
| NLR | Clinical trial | 2021 | CRPC patients (n=63) | Use NLR could further classify patients into different risk groups | Small sample size, lack of independent validation, not adjusting important confounders | (27) |
| NLR | Clinical trial | 2019 | CRPC patients (n=303) | NLR ≥ 2.5 at CRPC diagnosis is associated with a lower risk for CSS | Retrospective study, lack standard therapeutic approach | (28) |
| NLR | Randomised phase III trial | 2016 | Patients with metastatic CRPC (n=755) | Patients with a low NLR at baseline were more likely to develop grade ≥3 neutropenia | Not available | (29) |
| NLR | Clinical trial | 2017 | mCRPC patients (n=47) | NLR might be a useful prognostic biomarker in mCRPC patients treated with CBZ | Retrospective study, small sample size, observation period was short | (30) |
| NLR | Clinical trial | 2019 | mCRPC patients (n=106) | The NLR might be a useful biomarker for predicting the prognosis of mCRPC patients who are treated with ENZ | Retrospective study, some data were missing, small sample size | (31) |
| NLR | Clinical trial | 2016 | CRPC patients (n=193) | NLR >3 during treatment with ENZ seems to have both prognostic and predictive value in CRPC patients | Small sample size, the absence of external validation | (32) |
| NLR | Clinical trial | 2017 | mCRPC patients (n=101) | Not observed a correlation between the different cut-off values of PLR or NLR and a PSA response ≥25% | Not available | (33) |
| NLR | Clinical trial | 2018 | mCRPC patients (n=189) | NLR could predict overall survival | Lack complete information, no patient-reported outcomes | (34) |
| NLR | Clinical trial | 2022 | BPH cases (n=494) and PCa cases (n=525) | PLR and NLR have a significant predictive value towards the development of metastatic disease but not in relation to variations in aggressiveness or T staging inside the non-metastatic PCa | Not available | (35) |
| NLR | Clinical trial | 2019 | BPH patients (n=43) and PCa patients (n=125) | NLR and PLR significantly increase in PCa patients with bone metastases and are valuable in the diagnosis of bone metastases in PCa patients | Not available | (36) |
| NLR | Clinical trial | 2016 | PCa patients (n=1,464) | The NLR value was significantly elevated in men with higher PSA | Retrospective study | (37) |
| NLR | Clinical trial | 2018 | Patients with bone metastasis of PCa (n=111) | Elevated NLR was independently predictive of poor prognosis | Retrospective study, treatment not consistent and randomized | (38) |
NLR, neutrophil-to-lymphocyte-count ratio; PCa, prostate cancer; PSA, prostate-specific antigen; PBx, prostate biopsy; GS, Gleason score; TRUS, trans rectal ultra sound; OS, overall survival; PFS, progression-free survival; RFS, recurrence-free survival; CSS, cancer-specific survival; PSARS, the prediction of the PSA response; RP, radical prostatectomy; BCR, biochemical recurrence; CRPC, castration-resistant PCa; mCRPC, metastatic CRPC; ENZ, enzalutamide; PLR, platelet-to-lymphocyte-count ratio; BPH, benign prostatic hyperplasia.