The use of peripheral blood cells as an assessment of inflammation in prostate cancer in patients attending in surgery department at ESUT teaching hospital, Parklane, Enugu, Nigeria

Clara N. Soronnadi, Nancy C. Ibeh, Francis O. Ugwene, Grace I. Amilo, Anthony J. Ede


Background: Full blood count (FBC) is a prerequisite investigation requested from all prostate cancer (PCa) patients pre and post treatment, poor parameter influences the outcome of cancers.

Methods: Total subjects consisted of 84 male subjects between the ages 41 to >80 years. Longitudinal study was conducted. Controls and test samples were collected at diagnosis and at different stages of the treatment. Demographic information was obtained using a questionnaire. The data was analyzed using IBM statistical package for social sciences (SPSS) PC, version 20.0; SPSS Inc., Chicago, III., USA; the receiver operating characteristic curve (ROC) curve was obtained via neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) ratios cut-off determinations. Cox proportional-hazards regression analyses the prognostic factors (duration, ratios) and overall survival (diagnosis to death or last follow-up). A paired sample t-test compared test of significance in pre/post treatment results. The analysis of variance (ANOVA) and Tukey HSD post-hoc, test susceptibility within age groups was done.

Results: Increased NLR and LMR were significantly associated with increased hazard ratio (HR) and OS at p<0.05 while PLR, no significant difference at P>0.05 in PCa. In complete blood count (CBC) and erythrocytic sedimentation rate (ESR), control and treatment period, all red blood cell (RBC) parameters showed a significant decrease at p<0.05 in treatment results compared to the pre-treatment results while total platelet (TPLT), total white blood cells (TWBC), NC, LC, ESR showed significant increase at p<0.05 in treatment results compared to pre-treatment results. Age group 41-50 years showed more susceptibility than other age groups with significant decrease at p<0.05 in NC, LC and increased MC.

Conclusions: This study supports CBC and ESR biomarkers as a prognostic tool in early detection, treatment and monitoring of disease progression in these subjects.


Prostate, Inflammation, CBC

Full Text:



National Cancer Institute. Prostate Cancer. 2014. Available at: Accessed on: 25 August 2020.

World Health Organization. World Cancer Report. 2014. Available at: Accessed on: 25 August 2020.

Wakai K. Descriptive epidemiology of prostate cancer in Japan and Western countries. Nippon Rinsho. 2015;63(2):207-12.

Catalona WJ. Prostate Cancer Screening. Med Clin North Am. 2018;102(2):199-214.

Bello JO. Predictors of survival outcomes in native sub Saharan black men newly diagnosed with metastatic prostate cancer. Br Med Clin Urol. 2017;17(1):39-41.

Erlinger TP, Muntner P, Helzlsouer KJ. WBC count and the risk of cancer mortality in a national sample of U.S. adults: results from the Second National Health and Nutrition Examination Survey mortality study. Cancer Epidemiol Biomark Prev. 2014;13:1052-6.

Margolis KL, Rodabough RJ, Thomson CA, Lopez AM, McTiernan A. Prospective study of leukocyte count as a predictor of incident breast, colorectal, endometrial, and lung cancer and mortality in postmenopausal women. Arch Int Med. 2017;167:1837-44.

Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646-74.

Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, Leibowitz-Amit R. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: A systematic review and meta-analysis. J Natland Cancer Institute. 2014;106:124-6.

Tsagozis P, Augsten M, Pisa P. All trans-retinoic acid abrogates the protumorigenic phenotype of prostate cancer tumor-associated macrophages. Int Immunopharmacol. 2014;23(1):8-13.

Cavassani KAMR, Habiel DM, Chen JF, Montes A, Tripathi M, Martins GA, et al. Circulating monocytes from prostate cancer patients promote invasion and motility of epithelial cells. Cancer Med. 2018;7(9):4639-49.

Spivack M, Brenner SM, Markham MJ, Snyder EL, Berkowitz D. Presumed immune thrombocytopenia and carcinoma: report of three cases and review of the literature. Am J Med Sc. 2009;278:153-6.

Mackall CL, Fleisher TA, Brown MR. Lymphocyte depletion during treatment with intensive chemotherapy for cancer. Blood. 2014;84:2221-8.

Sylman JL, Mitrugno A, Tormoen GW, Wagner TH, Mallick P, McCarty OJ. Platelet count as a predictor of metastasis and venous thromboembolism in patients with cancer. Converg Sc Physic Oncol. 2017;3:2-5.

Nieder C, Haukland E, Pawinski A, Dalhaug A. Anaemia and thrombocytopenia in patients with prostate cancer and bone metastases. Biomed Central Cancer. 2010;10:284-6.

Pedio G, Ruttner J.R, Odermatt B, Gut D. Oncogenic viruses in the

Thrombocytopenic stage of experimental hipa–plasmacytoma. Experientia. 2014;30:289-91.

Choi ES, Kim HS, Han I. Elevated preoperative systemic inflammatory markers predict poor outcome in localized soft tissue sarcoma. Ann Surg Oncol. 2014;21:778-85.

Bochen K, Krasowska A, Milaniuk S, Kulczynska M, Prystupa A, Dzida G. Erythrocyte sedimentation rate-an old marker with new applications. J Pre-Clin Res. 2011;5:50-5.

Johansson JE, Sigurdsson T, Holmberg L, Bergström R. Erythrocyte sedimentation rate as a tumor marker in human prostatic cancer. An analysis of prognostic factors in 300 populations-based consecutive cases. Cancer. 2012;70:1556-63.

National Cancer Institute. Surveillance Epidemiology and End Results Program (SEER). 2016. Available at: Accessed on: 25 August 2020.

Ben-Shlomo Y, Evans S, Ibrahim F. The risk of prostate cancer amongst black men in the United Kingdom: the PROCESS cohort study. Eur Urol. 2008;53:99-105.

Knaus WA, Wagner DP, Draper EA. The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest. 2010;100:1619-36.

Brawley OW. Trends in Prostate Cancer in the United States. J Nat Cancer Institute Monographs. 2012;152-6.

Carroll PR, Parsons JK, Andriole G. Prostate cancer early detection, version 2. J Natland Comprehens Cancer Network. 2016;14:509-19.

Lozano Martinez AJ, Moreno Cano R, Escobar Paramo S. Platelet-lymphocyte and neutrophil-lymphocyte ratios are prognostic but not predictive of response to abiraterone acetate in metastatic castration-resistant prostate cancer. Clin Transl Oncol. 2017;19:1531-6.

Langsenlehner T, Pichler M, Thurner EM. Evaluation of the platelet-to-lymphocyte ratio as a prognostic indicator in a European cohort of patients with prostate cancer treated with radiotherapy. Urol Oncol. 2015;33:209-16.

Li F, Hu H, Gu S. Platelet to lymphocyte ratio plays an important role in prostate cancer's diagnosis and prognosis. Int J Clin Exp Med. 2015;8:11746-51.

Cao J, Zhu X, Zhao X, Li XF, Xu R. Neutrophil-to-lymphocyte ratio predicts PSA response and prognosis in prostate cancer: a systematic review and meta-analysis. PLoS one. 2016;11(7):1-5.

Linton A, Pond G, Clarke S, Vardy J, Galsky M, Sonpavde G. Glasgow prognostic score as a prognostic factor in metastatic castration-resist-ant prostate cancer treated with docetaxel-based chemotherapy. Clin Genitour Cancer. 2013;11(4):423-30.

Yasui MHY, Kawahara T, Kumano Y, Miyoshi Y, Matsubara N, Uemura H. Baseline neutrophil-to-lymphocyte ratio predicts the prognosis of castration- resistant prostate cancer treated with abiraterone acetate. Mol Clin Oncol. 2018;8(4):592-4.

Wang J, Liu Y, Zhang N, Li X, Xin P, Bi J, Kong C. Prognostic role of pre-treatment platelet to lymphocyte ratio in urologic cancer. Oncotarget. 2017;8(41):70874-82.

Sun Z, Ju Y, Han F, Sun X, Wang F. Clinical implications of pre-treatment inflammatory biomarkers as independent prognostic indicators in prostate cancer. J Clin Lab Analysis. 2017;32(3):22277.

Lolli C, Caffo O, Scarpi E. Systemic immune-inflammation index predicts the clinical outcome in patients with mCRPC treated with abiraterone. Front Pharmacol. 2016;7:376-9.