In the diagnosis of prostatic diseases, the need for markers other\nthan prostate specific antigen (PSA) has been increasing in recent years.\nSo, we aimed to determine the predictive value, the neutrophil lymphocyte\nratio, platelet-to-lymphocyte ratio and mean platelet volume before prostate\nbiopsy in predicting the results of pathology. Transrectal ultrasound-guided\nbiopsy of the prostate was performed because of high PSA values and compared\nvalues of these parameters to predict of pathology results. Methods:\n2715 patients who underwent 10 - 12 quadrant transrectal ultrasound-guided\nprostate biopsies between January 2008 and January 2018 have been evaluated\nretrospectively. Patients were divided into groups according to the biopsy\npathology results by benign (group 1), atypical small acinar proliferation\n(ASAP) (group 2) and prostate cancer (group 3). A total of 204 patients who\nwere benign prostate hyperplasia in 71 patients (34.8%), atypical small acinar\nproliferation in 80 (39.21%) and prostate adenocarcinoma (PCa) in 53 patients\n(25.98%) were included in the study by systematic sampling. Before the\nbiopsy total PSA (tPSA), free PSA (fPSA), rate of percentage of free to total\nprostate specific antigen (f/tPSA) rate, PSA density (PSA-D), white blood cell\n(WBC) count, blood neutrophil count (NC), blood lymphocyte count (LC),\nneutrophil lymphocyte ratio (NLR), mean platelet volume (MPV), platelet\ncount (PLT) and platelet-to-lymphocyte ratio (PLR) were measured and\ncompared in all groups. Differences in continuous variables were assessed\nusing the ANOVA. Logistic regression was used to analyze the linear relationship\nbetween predictive variables and pathology results. P < 0.05 was\nconsidered statistically significant. Results: NLR and PLR values were lower\nin group 1 than group 2 and were found statistically significant between in\ngroup 1 and group 2 (p: 0.03 and p: 0.02, respectively). MPV value was found\n1.7 times higher in patients who were diagnosed with ASAP pathology than\nthose with benign pathologies. Although there was statistically significant increase\nin MPV values in logistic regression results, no statistically significant\ndiagnostic value was found. In addition MPV value was found 0.5 times\nhigher in patients who were diagnosed patients with ASAP than prostate\ncancer group. ROC analysis showed that the optimal threshold was 7.65 femtoliter\n(sensitivity: 51%; specificity: 30%) and was found to be a statistically\nsignificant diagnostic value to distinguish groups 2 and 3. The lowest value of\nMPV was found in group 3. Conclusions: In cases where the PSA value is\ninsufficient in predicting the pathology result, the effect of NLR, PLR and\nMPV on differential diagnosis can be kept in mind. While NLR and PLR are\nmore useful in the diagnosis of ASAP, MPV is more effective in the diagnosis\nof malignancy.
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