Abstract：Objective To detect neutrophiltolymphocyte ratio (NLR) alone or in combination with prostate specific antigen (PSA) and age predicts the clinical value of prostate cancer（PCa） and its relationship with risk grade.Methods From June 2016 to June 2020, 1 205 patients who came to the department of urology at the third affiliated hospital of Xinxiang medical college and the first affiliated hospital of Xinxiang medical college were collected. The patients were divided into control group (1 060 cases) and PCa group (145 cases), PCA patients were divided into low, medium and high risk groups according to the guidelines of the European Urological Association.The general clinical data of the two groups of patients were compared, singlefactor and multifactor logistic regression analysis of risk factors affecting PCa. Receiver operating characteristic (ROC) curves were used to evaluate the clinical value of NLR, PSA and age alone in predicting PCa, and a combined prediction model equation was established. NLR levels among different PCa risk grades were compared.Results Age, PSA, fasting blood glucose (FBG), NLR and monocytetolymphocyte ratio (MLR) and the PCa group were higher than those in the control group, and lymphocyte counts were lower than those in the control group,the difference was statistically significant (all P<0.05).Univariate logistic regression analysis showed that age, PSA, lymphocyte count, hemoglobin, FBG and NLR were associated with PCa (all P<0.05).Multivariate logistic regression analysis showed that age, PSA and NLR were independent risk factors for PCa (P<0.05). The clinical value of PSA and NLR in predicting PCa was higher than that of age (Z=8.604, 9.204, all P<0.001).The ROC curve was established by the combined detection of NLR, PSA and age, the area under curve was 0.905, and the sensitivity and specificity were 82.5% and 80.7%.The NLR levels in the lowrisk group, intermediaterisk group and highrisk group were (2.05±0.26), (2.36±0.34) and (2.75±0.61), respectively, and there was a significant difference among the three groups (F=32.021,all P<0.001), and the NLR level in the highrisk group was higher than that in the intermediaterisk group and the lowrisk group (q=11.132, 6.494, all P<0.001), and the NLR level in the intermediaterisk group was higher than that in the lowrisk group (q=5.709,P<0.001).Conclusions NLR is an independent risk factor for PCa and is related to the risk classification of patients. Combined detection with PSA and age can effectively predict PCa.
