Neutrophil-to-lymphocyte ratio (NLR) may be useful as a surrogate marker of intravesical prostatic protrusion (IPP) in men with benign prostatic hyperplasia, according to a new report.

IPP is an anatomical feature caused by the growth of prostatic lateral and median lobes.

The new finding is from a study of 250 men older than 50 years who presented with lower urinary tract symptoms. Investigators found that NLR correlated positively with IPP and independently predicts IPP of 10 mm or greater.

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Among men with a total prostate volume (TPV) smaller than 40 cm3, mean NLR was 2.50 in those with IPP 10 mm or greater and 1.71 in those with IPP less than 10 mm, Mun Su Chung, MD, of Catholic Kwandong University in Incheon South Korea, reported in Lower Urinary Tract Symptoms. NLR differed significantly between men with a prostate smaller than 40 cm3 and IPP 10 mm or larger and those with a larger prostate and IPP less than 10 mm (2.50 vs 2.07, respectively).

The mean NLR was significantly greater among men with IPP 10 mm or larger than in those with a smaller IPP (2.60 vs 1.90).

“In conclusion, our analysis demonstrated that NLR can be used as a surrogate marker for presence of a specific morphological change, IPP,” the authors wrote. “The clinical value of NLR would be especially important in men with a small prostate gland but high IPP. The NLR was more strongly correlated with IPP than with TPV.”

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The authors noted that NLR has been proposed as a surrogate marker for various conditions, including biochemical failure in prostate cancer, cancer-specific survival of patients with metastatic renal cell carcinoma, and spontaneous passage of ureteral stones.


Chung MS, Yang YJ, Lee SH, Yoon BI. Association between the neutrophil-to-lymphocyte ratio and intravesical prostatic protrusion in men with benign prostatic hyperplasia [published online September 15, 2019]. Low Urin Tract Symptoms. doi: 10.1111/luts.12287