Materials and Methods
The database of 225 patients who had undergone transrectal ultrasound guided prostate biopsy or prostate surgery, performed between January 1, 2015 to December 31, 2018 at the Hitit University Erol Olçok Education and Research Hospital, was analyzed retrospectively. A local ethics committee confirmed our study, and all patients signed consent forms. Our study also complied with the principles of the Declaration of Helsinki.
PSA, free PSA (fPSA), hemoglobin, albumin, lymphocyte, and platelet levels were measured before the prostate biopsy or transurethral resection. Prostate biopsies were performed by an 18-gauge tru-cut biopsy needle under local anesthesia at twelve cores, while transurethral prostate resection was performed under general or spinal anesthesia using bipolar system.
Patients with the level of PSA above 20 ng/ml, with a history of acute or chronic prostatitis, dutasteride therapy, urethral instrumentation in the last month leading up to the biopsy, a pathological report of high grade prostatic intraepithelial neoplasia, and/or atypical small acinar proliferation, were excluded from the study.
The HALP score was calculated as hemoglobin level (g/L) × albumin level (g/L) × lymphocyte (/L) / platelet count (/L) (17). The patients were then divided into two groups; Group 1 had benign prostate hyperplasia (BPH), and Group 2 consisted of patients with prostate cancer (PCa).
The statistical analyses were performed using MedCalc Statistical Software demo version 16.2.0 (MedCalc Software bvba, Ostend, Belgium; https://www.medcalc.org; 2016). The data of the groups were compared with the independent sample t test, expressed as mean ± standard error, and p < 0.05 was considered as statistically significant. The receiver operating characteristic (ROC) curve analysis was performed to compare the ability of PSA, hemoglobin, albumin level, lymphocyte, platelet count and the HALP score to identify prostate cancer patients.