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.