The therapeutic efficacy for advanced prostate cancer (PCa) exhibits significant individual variation, necessitating the identification of effective prognostic indicators in clinical practice.

To investigate the relationship between the levels of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), monocyte-to-lymphocyte ratio (MLR) and disease prognosis in patients with advanced PCa.

A total of 89 patients with advanced PCa initially diagnosed at the First Affiliated Hospital of Anhui University of Science and Technology from 2020 to 2022 were enrolled as the study subjects, with follow-up until December 31, 2024. Based on recurrence or not within two years, patients were divided into a poor prognosis group (n=30) and a favorable prognosis group (n=59). General clinical data (including age, history of diabetes, hypertension, coronary heart disease, etc.) and laboratory parameters [NLR, platelet-to-lymphocyte ratio (PLR), SII, MLR, serum prostate-specific antigen (PSA), free prostate-specific antigen (FPSA), and the FPSA/PSA ratio] were compared between the two groups. Multivariate Logistic regression analysis was performed to identify factors influencing poor prognosis in PCa patients. Receiver operating characteristic(ROC) curve analysis was conducted to evaluate the predictive value of these indicators for poor prognosis.

The proportion of patients with a history of hypertension, as well as the levels of NLR, SII, and MLR, were significantly higher in the poor prognosis group compared to the favorable prognosis group(P<0.05). Multivariate Logistic regression analysis revealed that elevated NLR (OR=1.917, 95%CI=1.040-3.535), SII (OR=1.006, 95%CI=1.002-1.010), and MLR (OR=182.211, 95%CI=1.742-19 063.546) were independent risk factors for poor prognosis in advanced PCa (P<0.05). ROC curve analysis demonstrated that the combination of NLR, SII, and MLR [Logistic regression equation: Logit (P)=-9.183+0.651×NLR+0.006×SII+5.205×MLR] yielded an area under the curve (AUC) of 0.926 for predicting poor prognosis in advanced PCa, which was superior to any single indicator alone (Z=2.444, 4.473, 2.071; P=0.015, <0.001, 0.038, respectively).

Elevated NLR, SII, and MLR are independent influencing factors for recurrence in patients with advanced PCa. The combination of these three parameters provides the highest predictive value for prognosis in this patient population.

晚期前列腺癌（PCa）治疗效果个体差异较大，临床上需要寻找有效判断PCa预后的相关指标。

探讨晚期PCa患者中性粒细胞与淋巴细胞比值（NLR）、系统性免疫炎症指数（SII）及单核细胞与淋巴细胞比值（MLR）水平与疾病预后的关系。

选取2020—2022年初次就诊于安徽理工大学第一附属医院的晚期PCa患者89例为研究对象，随访时间截至2024-12-31。依据2年内是否复发将患者分为预后不良组（30例）、预后良好组（59例），对比两组患者的一般资料（年龄和糖尿病史、高血压史、冠心病史等）、实验室检查指标[NLR、血小板与淋巴细胞比值（PLR）、SII、MLR、血清前列腺特异性抗原（PSA）、游离前列腺特异抗原（FPSA）、FPSA/PSA等]。采用多因素Logistic回归分析探讨PCa患者预后不良的影响因素，绘制受试者工作特征（ROC）曲线，分析指标对患者预后不良的预测价值。

预后不良组高血压病史所占比例、NLR、SII、MLR高于预后良好组（P<0.05）。多因素Logistic回归分析结果显示，NLR（OR=1.917，95%CI=1.040~3.535）、SII（OR=1.006，95%CI=1.002~1.010）、MLR（OR=182.211，95%CI=1.742~19 063.546）升高是晚期PCa预后不良的独立危险因素（P<0.05）。ROC曲线分析显示，NLR、SII及MLR联合[Logistic回归方程为Logit（P）=-9.183+0.651×NLR+0.006×SII+5.205×MLR]预测晚期PCa预后不良的ROC曲线下面积（AUC）为0.926，高于任一指标单独检测（Z值分别为2.444、4.473、2.071，P值分别为0.015、<0.001、0.038）。

NLR、SII、MLR升高是晚期PCa患者复发的独立影响因素，三者联合在晚期PCa患者中预测预后价值最高。