术前炎症标志物和血清CA 125水平对印度尼西亚上皮性卵巢癌女性手术结局的预测价值。

Predictive value of preoperative inflammatory markers and serum CA 125 level for surgical outcome in Indonesian women with epithelial ovarian cancer.

作者信息

Sastra Winata I Gde, Aditya Prayudi Pande Kadek, Gradiyanto Ongko Eric, Ketut Suwiyoga

机构信息

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia.

Department of Obstetrics and Gynecology, Faculty of Medicine Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia.

出版信息

Cancer Biomark. 2022;34(1):123-129. doi: 10.3233/CBM-201415.

DOI:10.3233/CBM-201415

PMID:34806598

Abstract

BACKGROUND

It is essential in the management of ovarian cancers to identify the patients who will benefit from primary complete cytoreductive surgery and those who will rather benefit from neoadjuvant chemotherapy.

OBJECTIVE

To evaluate the predictive value of preoperative inflammatory markers, i.e. platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), red cell distribution width (RDW), and serum CA125 level for surgical outcome in epithelial ovarian cancer.

METHODS

A retrospective study was carried out in Sanglah Hospital, Denpasar, Bali. A total of 54 patients with epithelial ovarian cancer who underwent primary exploratory laparotomy from January 2018 to November 2019 was recruited. Data about clinical characteristics, preoperative inflammatory markers, serum CA125 level, and surgical outcome (optimal vs. suboptimal) was collected from the medical records. Predictive value of the markers were evaluated using ROC curve to determine their accuracy (area under the curve, sensitivity, specificity, positive and negative predictive value).

RESULTS

Mean age, parity, and tumor size did not differ between the study groups (p> 0.05). The group with suboptimal outcome had significantly higher PLR, NLR, MLR, and RDW value (p< 0.05). Using the ROC curve, a cut off value was determined for each predictor, i.e. PLR: 196.50, NLR: 3.34, MLR: 0.24, RDW: 13.19, CA125: 300.85. AUC for each predictor were as follows: PLR 0.718 (95% CI: 0.578-0.859), NLR 0.676 (95% CI: 0.529-0.823), MLR 0.700 (95% CI: 0.560-0.839), RDW 0.712 (95% CI: 0.572-0.852), CA125 0.593 (95% CI: 0.436-0.750). Sensitivity, specificity, and accuracy for predicting suboptimal outcome were as follows: PLR (74.2%, 69.6%, 72.2%), NLR (64.5%, 60.9%, 62.9%), MLR (74.2%, 59.1%, 66.7%), RDW (74.2%, 60.9%, 68.5%), CA125 (54.8%, 60.9%, 57.4%). We have some limitations such as small numbers of sample, we generalized whole kinds of ovarian cancer, and this study does not describe follow-up features.

CONCLUSION

Preoperative serum inflammatory markers (PLR, MLR, and RDW) may serve as useful markers to predict the surgical outcome with fair accuracy in patients with epithelial ovarian cancer.

摘要

背景

在卵巢癌的治疗中，识别出能从初次完全减瘤手术中获益的患者以及更适合接受新辅助化疗的患者至关重要。

目的

评估术前炎症标志物，即血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、红细胞分布宽度（RDW）以及血清CA125水平对上皮性卵巢癌手术结局的预测价值。

方法

在巴厘岛登巴萨的桑格拉医院开展一项回顾性研究。纳入了2018年1月至2019年11月期间接受初次 exploratory laparotomy（此处可能有误，推测为“剖腹探查术”）的54例上皮性卵巢癌患者。从病历中收集有关临床特征、术前炎症标志物、血清CA125水平以及手术结局（最佳与次优）的数据。使用ROC曲线评估这些标志物的预测价值，以确定其准确性（曲线下面积、敏感性、特异性、阳性和阴性预测值）。

结果

研究组之间的平均年龄、产次和肿瘤大小无差异（p>0.05）。手术结局为次优的组PLR、NLR、MLR和RDW值显著更高（p<0.05）。使用ROC曲线，为每个预测指标确定了一个临界值，即PLR：196.50，NLR：3.34，MLR：0.24，RDW：13.19，CA125：300.85。每个预测指标的AUC如下：PLR 0.718（95%CI：0.578 - 0.859），NLR 0.676（95%CI：0.529 - 0.823），MLR 0.700（95%CI：0.560 - 0.839），RDW 0.712（95%CI：0.572 - 0.852），CA125 0.593（95%CI：0.436 - 0.750）。预测次优结局的敏感性、特异性和准确性如下：PLR（74.2%，69.6%，72.2%），NLR（64.5%，60.9%，62.9%），MLR（74.2%，59.1%，66.7%），RDW（74.2%，60.9%，68.5%），CA125（54.8%，60.9%，57.4%）。我们存在一些局限性，如样本数量少，我们将所有类型的卵巢癌进行了归纳，并且本研究未描述随访特征。