Marin Alina-Gabriela, Filipescu Alexandru George, Petca Răzvan Cosmin, Vlădăreanu Radu, Petca Aida
"Carol Davila" Faculty of Medicine, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Obstetrics and Gynaecology, Elias Emergency University Hospital, 011461 Bucharest, Romania.
Cancers (Basel). 2024 May 20;16(10):1935. doi: 10.3390/cancers16101935.
Endometrial cancer is associated with changes in blood cell counts and with high levels of inflammatory markers, thus reflecting the tumor's impact on various biological processes and suggesting their potential as biomarkers for endometrial cancer diagnosis, prognosis, and treatment response. The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in peripheral blood sampled preoperatively from patients have been reported to be independently associated with the prognosis of different types of malignancies. This study aimed to compare several blood markers-red blood cells, white blood cells, platelet parameters, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, C-reactive protein, and fibrinogen-in patients with benign or malignant endometrial tumors. Our retrospective study included 670 patients (192 diagnosed with endometrial cancer and 478 with endometrial hyperplasia), and we compared the serological parameters discussed above with those sampled the day before surgery. Analysis of complete blood count indices revealed no significant differences in red blood cell or total white blood cell parameters between the endometrial cancer group and the endometrial hyperplasia group. However, a distinct pattern emerged in the white blood cell differential. The endometrial cancer group showed a statistically significant decrease in lymphocyte count compared with the endometrial hyperplasia group. In contrast, the endometrial cancer group showed significantly higher mean platelet counts and increased mean platelet volume compared with controls. Furthermore, the endometrial cancer group demonstrated a marked inflammatory response, as evidenced by significantly elevated levels of C-reactive protein, fibrinogen, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio compared with the endometrial hyperplasia group. The current research revealed statistically significant differences in multiple serological biomarkers between the two groups. These findings support the initial hypothesis regarding the potential utility of these biomarkers in endometrial cancer diagnosis, prognosis, and treatment response, highlighting the existence of biomarkers affordable for analysis under any health system, regardless of the country's level of development.
子宫内膜癌与血细胞计数变化及高水平炎症标志物相关，从而反映出肿瘤对各种生物学过程的影响，并表明它们作为子宫内膜癌诊断、预后及治疗反应生物标志物的潜力。据报道，术前采集的患者外周血中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及单核细胞与淋巴细胞比值与不同类型恶性肿瘤的预后独立相关。本研究旨在比较良性或恶性子宫内膜肿瘤患者的几种血液标志物——红细胞、白细胞、血小板参数、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、单核细胞与淋巴细胞比值、C反应蛋白及纤维蛋白原。我们的回顾性研究纳入了670例患者（192例诊断为子宫内膜癌，478例为子宫内膜增生），并将上述血清学参数与术前一天采集的参数进行了比较。全血细胞计数指标分析显示，子宫内膜癌组与子宫内膜增生组之间的红细胞或总白细胞参数无显著差异。然而，白细胞分类出现了明显的模式。与子宫内膜增生组相比，子宫内膜癌组淋巴细胞计数在统计学上显著降低。相反，与对照组相比，子宫内膜癌组平均血小板计数显著更高，平均血小板体积增加。此外，与子宫内膜增生组相比，子宫内膜癌组C反应蛋白、纤维蛋白原、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及单核细胞与淋巴细胞比值水平显著升高，表明存在明显的炎症反应。目前的研究揭示了两组之间多种血清学生物标志物存在统计学上的显著差异。这些发现支持了关于这些生物标志物在子宫内膜癌诊断、预后及治疗反应中潜在效用的最初假设，突出了在任何卫生系统下均可负担得起分析费用的生物标志物的存在，而不论国家的发展水平如何。
