Predictive Value of Systemic Immune-Inflammation Index for Infectious Complications Following Transrectal Ultrasound-Guided Prostate Biopsy

Abstract:Aim: This study aimed to evaluate the predictive value of the systemic immune-inflammation index (SII) for infectious complications following transrectal ultrasound-guided prostate biopsy. Materials and Methods: This retrospective study included 342 patients who underwent transrectal ultrasound-guided prostate biopsy. Inflammatory indices were calculated prior to biopsy using complete blood count parameters. In addition to the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were also evaluated. Inflammatory indices were compared between patients with and without post-biopsy infection using nonparametric statistical tests. Receiver operating characteristic (ROC) curve analysis was applied to evaluate predictive performance.Results: Post-biopsy infection occurred in 33 patients (9.6%). No statistically significant differences were observed in SII, NLR, PLR, or MLR values between patients with and without post-biopsy infection (all p > 0.05). While SII values showed a tendency to be higher in the group of patients experiencing post-biopsy infection, these differences were not statistically significant (p = 0.069). ROC analysis revealed poor discriminatory performance for all inflammatory indices; with area under the curve values were 0.596 for SII, 0.585 for NLR, 0.558 for PLR, and 0.522 for MLR.Conclusion: Pre-biopsy inflammatory indices demonstrated limited predictive performance for post-biopsy infectious complications. Future prospective multicenter studies integrating inflammatory, clinical, and microbiological parameters are needed.Keywords: Biomarkers; Biopsy; Inflammation; Prostate; Sepsis.Word count: 217