Bacanakgil Besim Haluk, Kaban Isik, Unal Fehmi, Guven Rabia, Sahin Ece, Yildirim Sezgi Gullu
Obstetrics and Gynaecology, İstanbul Training and Research Hospital, Turkey. Email:
Asian Pac J Cancer Prev. 2018 Jun 25;19(6):1529-1532. doi: 10.22034/APJCP.2018.19.6.1529.
Objective: To investigate the predictive role of neutrophil lymphocyte ratio (NLR) and the platelet lymphocyte ratio (PLR) as hematological inflammatory markers in cases of endometrial hyperplasia and cancer. Material and Method: This retrospective study was performed between 2005-2015 with 247 cases of 83 endometrial adenocarcinoma (group 1), 64 of endometrial hyperplasia (group 2) and 100 controls (group 3) who underwent a curettage due to abnormal uterine bleeding and had a normal histopathology in our tertiary clinic. The cases were chosen from patients without chronic diseases, that do not have infection or medication that could affect the systemic inflammatory response. Preintervention blood parameters were taken into account. The neutrophil/ lymphocyte and platelet/lymphocyte ratios were and statistical comparisons of the groups were conducted. Results: The age distribution of 247 patients was between 26 and 85 years, and the mean age was 48.8 ± 8.92.The median age was 54 in group 1, 46 in group 2 and 45 in group 3. The age was significant between group 1 and the other groups (p=0.001). Some 71% of the cases were premenopausal and 29% were postmenopausal, the latter being significantly more frequent in group 1 (62.7%; p=0.001). Of the cases with endometrial hyperplasia, 42 (65.6%) had simple and 22 (34.4%) have atypical-complex lesions. The median NLRs in groups 1, 2, and 3 were 2.15, 2.10, and 1.92, respectively, with median PLRs of 135.1, 134.0 and 145.6. There was a statistically significant difference between the NLR measurements of the cases from different groups (p=0.048; p<0.05). The NLR value for the endometrial adenocarcinoma group was significantly higher than for the control group (p=0.033; p<0.05). The optimum cut-off value was calculated to be ≥4, at which sensitivity was 20.5%, specificity 99%, positive predictive value (PPV) 94.4% and negative predictive value (NPV) 60%. Conclusion: The value of NLR ≥4 has predictive significance in distinguishing endometrial pathologies before intervention in patients with abnormal uterine bleeding. Simple, cheap and easy-to-perform, the NLR can be used as a potential hematological marker for endometrial malignancy.
探讨中性粒细胞淋巴细胞比值（NLR）和血小板淋巴细胞比值（PLR）作为血液学炎症标志物在子宫内膜增生和癌症病例中的预测作用。材料与方法：本回顾性研究于2005年至2015年进行，纳入247例患者，其中83例为子宫内膜腺癌（第1组），64例为子宫内膜增生（第2组），100例为对照组（第3组），这些患者因异常子宫出血接受刮宫术，且在我们的三级诊所组织病理学检查正常。病例选自无慢性疾病、无感染或无可能影响全身炎症反应药物的患者。考虑干预前的血液参数。计算中性粒细胞/淋巴细胞和血小板/淋巴细胞比值，并对各组进行统计学比较。结果：247例患者的年龄分布在26至85岁之间，平均年龄为48.8±8.92岁。第1组的中位年龄为54岁，第2组为46岁，第3组为45岁。第1组与其他组之间的年龄差异有统计学意义（p = 0.001）。约71%的病例为绝经前，29%为绝经后，后者在第1组中更为常见（62.7%；p = 0.001）。在子宫内膜增生病例中，42例（65.6%）为单纯性病变，22例（34.4%）为非典型复杂性病变。第1、2、3组的NLR中位数分别为2.15、2.10和1.92，PLR中位数分别为135.1、134.0和145.6。不同组病例的NLR测量值之间存在统计学显著差异（p = 0.048；p < 0.05）。子宫内膜腺癌组的NLR值显著高于对照组（p = 0.033；p < 0.05）。计算得出最佳截断值为≥4，此时敏感性为20.5%，特异性为99%，阳性预测值（PPV）为94.4%，阴性预测值（NPV）为60%。结论：NLR≥4在区分子宫异常出血患者干预前的子宫内膜病变方面具有预测意义。NLR简单、廉价且易于操作，可作为子宫内膜恶性肿瘤潜在的血液学标志物。
