Elevated Plasma Fibrinogen And The Neutrophil-To-Lymphocyte Ratio As Predictive Risk Factors For Prostate Cancer

Background: The relationship between inflammatory markers and prostate cancer (PCa) remains controversial. This study was designed to evaluate the role of inflammatory factors in predicting the risk of PCa. Methods: A retrospective analysis was performed on 460 patients who underwent prostate biopsy and pre-operative blood sample collection. Neutrophil, lymphocyte, monocyte, and platelet counts as well as fibrinogen (FBG) levels were obtained, and the ratios of neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR) were calculated. The correlations of these factors with the demographic, clinical, and histopathologic outcomes were analyzed using the Mann-Whitney or Kruskal-Wallis tests. A logistic regression analysis was used to screen the risk indicators of PCa. Using the receiver operating curve method, we determined the optimal cut-off level for FBG to assess the predictive value of the new model. Results: NLR and FBG were determined to be independent risk factors for PCa. Furthermore, FBG was determined to be an independent risk factor for local advanced PCa. Both NLR and FBG levels were correlated positively with the clinical and pathological characteristics of PCa. Patients with higher FBG may have higher risk grades and clinical stages based on the 3.015 stratification of FBG. The new predictive model composed of NLR, FBG, and prostate-specific antigen exhibits a greater predictive value in detecting PCa. Conclusions: NLR and FBG are independent risk factors for PCa. Furthermore, pre-treatment FBG greater than 3.015 may indicate higher risk grades and clinical stages in patients with PCa. NLR and FBG may be low-cost and high-efficiency clinical biomarkers, which can be combined with prostate-specific antigen to form a new prediction model, improving the predictive efficiency for PCa.