Prostate cancer (PCa) is also one of the most common cancers in worldwide and diagnostic tools of PC by prostate specific antigen (PSA). The increasing incidence of PCa related mortality rate has been reduced [1-2]. It has been differed in tumor markers and contributes to genetic factors, metabolic disturbances that happen in the prostatic tissue, benign prostatic hyperplasia and prostatic cancer [3-5]. The incidence of prostate cancer varies remarkably in different countries and regions, which increased significantly during the past few decades due to diverse approaches to diagnosing PCa. Despite different treatment methods including radical prostatectomy, hormone deprivation therapy, radiation therapy and chemotherapy were applied, most tumours relapse in 2 years to the castration-resistant state and the prognosis of PCa remains disappointing [6-7]. Given this, it is of interest for clinicians to stratify the high-risk PCa patients who are prone to tumour recurrence and poor prognosis so that clinicians could further identify optimal treatment strategies [8]. The changes in systemic inflammatory response can be reflected by the measurement of various blood-based parameters. A variety of blood-based indexes including C-reactive protein (CRP), modified Glasgow Prognostic Score (mGPS), platelets count and neutrophil-to-lymphocyte ratio (NLR) has been extensively explored to predict the prognosis of cancer patients. A large number of studies have reported that elevation of NLR was associated with poor clinical outcomes in various malignant tumours [9]. In recent years, several studies have reported that an elevation in NLR correlated with biological tumor recurrence and poor prognosis in patients with PCa. The prostate specific antigen and prostate acid phosphatase were used for the diagnosis of prostatic cancer [10]. PSA is a glycoprotein that contains 237 amino acids produced by the lamina of the prostate gland and circulated in the bloodstream exist 2 major forms [11]. The PSA levels are useful for prostate cancer detection and predict prognosis in men with prostate cancer undergoing therapy. The prevalence of symptomatic prostatitis was 9% in men above the age of 40 years, although the prevalence of asymptomatic prostatitis was unknown [12]. In addition, prostatic lesions called proliferative inflammatory atrophy and prostatic intraepithelial neoplasia are considered precursors of prostate cancer [13-14]. This term includes focal atrophic lesions as well as chronic inflammation.

Ethical considerations and Permission: All the subjects were recruited in the study after obtaining their informed consent after obtaining of ethical clearance from the institute.

Statistical Analysis: The normal distribution of data was checked by using the Kolmogorov Smirnov test. All the characters are descriptively summarized. The mean and standard deviation of the arithmetic mean were used. Variations in the serum Prostate Specific Antigen (PSA was analysed by using Student’s T-Tests (2 Tailed). The correlation between the PSA, CBC was done by using Pearson Correlation analysis. The Data has been compiled in Microsoft Excel spreadsheets and analyzed using SPSS for windows version 16.0. A p-value <0.05 was considered statistically significant.

Table – 1 shows the mean values and SD of patient’s charactertic’s and various parameters studied inprostate cancer and healthy controls. Significant difference was observed hemoglobin (9.15 ± 0.72, 12.83 ± 0.31 P - 0.0001*), Red blood cells (2.51 ± 1.92, 4.28 ± 0.14, P- 0.002*), WBCs (2011.54 ± 30.66, 6045.15 ± 25.24, P- 0.0001*), Platelets (1.02 ± 0.29, 4.38 ± 17.36, P- 0.0001*), Neutrophils (35.62 ± 6.49,5.25 ± 35.07, P- 0.004*), PSA (9.68 ± 2.11, 5.13 ± 1.56, P - 0.001*) in the groups of prostatic cancer patients. Significantly higher levels of serum prostate specific antigen and decreased levels were observed in patients with prostate cancer on treatment when compared with newly diagnosed prostate cancer patients (p<0.001).

Table-1. Comparison of biochemical parameters in patients with two groups of Prostate Cancer

Table – 2 shows the positive correlation of SerumPSA and complete blood count in both the groups of prostatic cancer patients.

Although most of these men will eventually experience rising PSA despite castrate levels of testosterone, little is known about the natural history of men with androgen-independent prostate cancer and no radiographic evidence of metastases [23]. To the best of our knowledge, this is the first analysis to prospectively evaluate the natural history of non-metastatic prostate cancer and rising PSA despite androgen deprivation therapy [24]. Notable features of the study design include confirmation of a castrate testosterone level at study entry, documentation of PSA progression with three serial rises, and radiographic screening to exclude men with bone metastases at study entry [25]. In addition, bone scans were obtained every 4 months to minimize PSA bias in defining the primary study outcome of time to first bone metastases.

Elevation in serum PSA levels after surgery or radiation therapy for early-stage prostate cancer typically predates clinically or radiographically detectable metastatic disease by several years, without additional treatment. In a retrospective series of 315 men with a rising serum PSA after radical prostatectomy for example, the median time to first bone metastasis was 8 years from the time of PSA elevation [26-28]. Three years following initial postoperative PSA elevation, only 27% of patients had radiographically detectable metastases. The results of our study suggest that rates of disease progression remain low for men with “PSA only” prostate cancer, even after androgen deprivation therapy. Prostate adenocarcinoma proliferation is highly dependent on circulating sex steroids, specifically testosterone and dihydrotestosterone, and the binding of these hormones to receptors on prostate cancer cells.

changes in sex steroid production, particularly decreased androgens and/or increased estrogens, can inhibit the growth and development of well-differentiated prostate cancers but may have little influence or even an undesirable effect on poorly differentiated prostate tumors [29-30]. This phenomenon has been demonstrated with finasteride, which decreases the conversion of testosterone to dihydrotestosterone by inhibition of the 5-alpha reductase enzyme. In the Prostate Cancer Prevention Trial, finasteride was found to significantly prevent or delay prostate cancer by almost 25% overall, however, the risk for having high-grade disease, specifically Gleason grade 7 to 10 tumors, was significantly increased [31].

Highly significant differences in the expression of genes related to immunobiology within the tumour microenvironment were identified between these two groups. This interpretation was supported by both disease association and pathway analyses. CBC, especially the systemic inflammatory parameters, contain many clues reflecting how the human mechanism works [34]. They are very helpful in the diagnosis of many diseases in addition to the physical examination findings. Recent studies have shown that CBC findings might also be used in tumoral diseases. The relationship between inflammation and cancer has been already known for decades. It has been known that some cancers develop on the ground of chronic inflammation or some infectious agents are involved in cancer etiology. However, during cancer development, inflammatory mediators play an important role in creating a microenvironment that will allow the tumour to grow and spread. Further, many studies suggest that not only the inflammatory response in the tumoral tissue but also the systemic inflammatory response is associated with the tumor prognosis [35-36]. Similar to the inflammatory cells, platelets play a role in the development of cancer. Platelets also contribute to the formation of angiogenesis by stimulating vascular and endothelial growth factors, in turn supporting cancer development [37]. Moreover, platelets play an active role in the metastatic process by facilitating the adhesion of cells to the vessels and the thrombocytosis is also associated with advanced or metastatic cancers and is regarded as a negative predictive marker for many cancers such as endometrial, cervical, ovarian, gastric, and esophageal carcinoma, and breast cancer.

This study suggesting that the serum Prostatic Specific Antigen (PSA) levels sensitive parameters for early detection of prostatic cancer and also for these patients frequent measurements of complete blood count useful for early detection of further complications.

In prostate cancers by using prostate specific antigens and prostate phosphatase were used for diagnosis and progression of prostatic cancers. But these prostate cancers leads to further complications on bone and liver, some blood-related