Inflammatory Blood Markers Add Marginal, Non-Significant Benefit for PI-RADS 3 Biopsy Decisions

In 982 biopsy patients, NLR ≥2.11 independently predicted clinically significant prostate cancer (OR 15.9; 95% CI 2.5–102.6), but adding SII+NLR to a clinical model raised AUC only from 0.795 to 0.816 in PI-RADS 3 patients (p=0.134, non-significant). Retrospective; wide CIs warr…

• Two-center retrospective study (n=982; PI-RADS 3 subgroup n=251); csPCa (ISUP Grade Group ≥2) rate was 15.3% overall and the gray-zone PI-RADS 3 group was the primary focus for model testing.
• In the PI-RADS 3 subgroup, SII ≥661.37 was an independent predictor of any PCa (OR 2.317, p=0.039), but the AUC gain from adding SII+NLR to age/f/t-PSA ratio/PSAD did not reach statistical significance (ΔAUC +0.021, p=0.134 by DeLong test).
• Key limitations: retrospective design, wide confidence intervals for the NLR odds ratio (2.5–102.6) suggesting possible overfitting or small event numbers, and no external validation cohort — clinical adoption is premature.

RadPigeon summaries are original and for information only. They are not clinical advice.