Role of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in Peyronie's disease: a new diagnostic approach to predict the stage of the disease?

Abstract

Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been associated with multiple entities and several types of cancers. They can be assumed as markers of inflammatory imbalance. The objective of this study is to evaluate the NLR and PLR in Peyronie's disease (PD) and to establish a comparison of its values in the acute and chronic stages. We recruited patients with PD from March 2018 to March 2019. The patients enrolled underwent medical and sexual history as well as a physical examination. The values of blood count of each patient were collected both in the acute and chronic stages. Wilcoxon test was used to compare the acute and chronic stage ratios. Kruskal-Wallis test was carried out to evaluate the impact of treatments on the ratios. To identify cutoff values, we used sensibility and specificity tables and receiver operating characteristic (ROC) curves. A total of 120 patients were enrolled. Their mean age was 55.85 (range: 18-77) years and the mean penile curvature was 48.43° (range: 10°-100°). In the acute stage, the mean NLR was 2.35 and the mean PLR was 111.22. These ratios, in the chronic stage, were 1.57 and 100.00, respectively. Statistically significant differences between acute and stable stages for both indices were found (NLR: P< 0.0001; PLR: P= 0.0202). The optimal cutoff for classification in acute or stable stage was 2 for NLR and 102 for PLR. According to our results, with an ordinary blood count, we could have important indications regarding the disease stage of the patient, and consequently on the most appropriate type of therapy to choose.

Keywords: Peyronie's disease; diagnosis; inflammation; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio.

Figure 1

Mean (a) NLR and (b) PLR in the acute and chronic stages of the disease. NLR: neutrophil-to-lymphocyte ratio; PLR: platelet-to-lymphocyte ratio.

Figure 2

ROC curves for Peyronie's disease stages. (a) Neutrophil-to-lymphocyte ratio curve. (b) Platelet-to-lymphocyte ratio curve. ROC: receiver operating characteristic; AUC: area under the curve.