There were currently no established standards for quantitatively assessing 68Ga-PSMA-PET/CT results for diagnosing lymph node metastases in prostate cancer patients. Hematological indicators associated with inflammation are valuable as accurate predictors of several cancer-related outcomes. For a study, researchers sought to investigate methods for 68Ga-PSMA-PET/CT for identifying lymph node metastases that are more useful by combining them with the examination of inflammatory hematological markers in prostate cancer patients.

Age, initial TPSA levels, hematological data, biopsy pathology results (Gleason score and ISUP grouping), radical pathology results, and patient imaging information were gathered before therapy. After determining the best cutoff values for each predictor based on Youden’s index, independent predictors of lymph node metastasis were found using univariate and multivariate analyses, and a nomogram was created.

SUVmax (odds ratio [OR]: 30.549, 95% CI: 10.855–85.973, P<0.001), neutrophil-lymphocyte ratio (OR:8.221, 95% CI: 1.335-50.614, P=0.023), platelet-lymphocyte ratio (OR:8.221, 95% CI: 1.335–50.614, P=0.023), initial TPSA (OR:2.761, 95% CI: 1.132–6.733, P=0.026) and clinical T-stage clinical T-stage (T3 vs. T2, OR:11.332, 95% CI:3.929–32.681, P<0.001; T4 vs. T2, OR:9.101, 95% CI:1.962–42.213, P=0.005) with corresponding optimal cutoff values of 2.3 (area under the curve [AUC]: 0.873, sensitivity: 0.736, specificity: 0.902), 1.72 (AUC: 0.558, sensitivity: 0.529, specificity: 0.643), 83.305 (AUC: 0.651, sensitivity: 0.299, specificity: 0.979), & 21.875 (AUC: 0.672, sensitivity: 0.736, specificity: 0.601) were the independent predictors of lymph node metastasis in the patient. With a C-index of 0.887 (95% CI: 0.793-0.981) and an AUC of 0.924 (95% CI: 0.882-0.965), further nomogram generation was linked with strong predictive ability.

In order to further enhance lymph node staging for prostate cancer patients, SUVmax, the neutrophil-lymphocyte ratio, the platelet-lymphocyte ratio, the initial TPSA, and the clinical T-stage all serve as valuable independent predictors of lymph node metastases.