Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Asian Pac J Cancer Prev. 2023 Feb 1;24(2):701-707. doi: 10.31557/APJCP.2023.24.2.701.
Differentiating uterine LMS from uterine leiomyoma is difficult. Therefore, this study aimed to compare preoperative NLR of uterine leiomyosarcoma (LMS) with leiomyoma and secondary objective aimed to identify the clinical characteristics to distinguish between uterine LMS and uterine leiomyoma including the appropriate NLR cut off value to differentiate LMS from leiomyoma.
This was a matched case-controlled study with 1:4 ratio. We collected data of patients with uterine LMS and leiomyoma from 2011 to 2020 at King Chulalongkorn Memorial Hospital. Patients with uterine LMS (case group) and leiomyoma (control group) were matched in terms of year of the surgery and size of the uterine mass. Statistical analysis was conducted using SPSS version 22.0 and STATA version 17. Conditional logistic regression analysis with a p-value of <0.05 was used.
Twenty-seven patients who were diagnosed with uterine LMS met the inclusion criteria; 13 patients who had incomplete data and one patient who was had concurrent breast cancer were excluded. Thirteen patients were included in the final analysis. From 2,587 patients in control group; 52 patients were matched. The baseline characteristics in both groups were comparable except for menopausal status Women with uterine LMS had a higher NLR than those with leiomyoma (mean, 4.56 ± 2.5 and 2.4 ± 1.15 in the case and control groups, respectively). Conditional logistic regression determined that the NLR cut-off value of 2.8 was a statistically significant factor for determining uterine LMS (OR = 3.24; 95% CI 1.01-10.43). No significant difference was found in the other factors.
Patients who were diagnosed with uterine LMS had a significantly higher NLR than those diagnosed with leiomyoma. The NLR is a simple and effective method for predicting the presence of a uterine LMS in patients who are pre-operatively diagnosed with a uterine mass.
区分子宫平滑肌肉瘤（LMS）与子宫肌瘤具有一定难度。因此，本研究旨在比较术前子宫平滑肌肉瘤（LMS）与子宫肌瘤患者的中性粒细胞与淋巴细胞比值（NLR），次要目标旨在确定鉴别 LMS 与子宫肌瘤的临床特征，包括区分 LMS 与子宫肌瘤的合适 NLR 截断值。
这是一项病例对照研究，采用 1:4 比例。我们收集了 2011 年至 2020 年在朱拉隆功国王纪念医院就诊的 LMS 与子宫肌瘤患者的数据。LMS 患者（病例组）与子宫肌瘤患者（对照组）按照手术年份和子宫肿块大小进行匹配。采用 SPSS 22.0 和 STATA 17 进行统计分析。采用 P 值<0.05 的条件逻辑回归分析。
符合纳入标准的 LMS 患者有 27 例，其中 13 例数据不完整，1 例同时患有乳腺癌，最终有 13 例患者纳入最终分析。在对照组的 2587 例患者中，有 52 例患者匹配。两组的基线特征除绝经状态外无差异，LMS 患者的 NLR 高于子宫肌瘤患者（分别为 4.56 ± 2.5 和 2.4 ± 1.15）。条件逻辑回归确定 NLR 截断值 2.8 是预测存在子宫 LMS 的统计学显著因素（OR=3.24；95%CI 1.01-10.43）。其他因素无显著差异。
术前诊断为子宫 LMS 的患者 NLR 显著高于术前诊断为子宫肌瘤的患者。NLR 是一种预测术前诊断为子宫肿块患者存在子宫 LMS 的简单有效的方法。
