Kurniadi Andi, Ridwan Steven, Hidayat Yudi Mulyana, Rauf Syahrul, Mantilidewi Kemala Isnainiasih, Winarno Gatot N A, Salima Siti, Suardi Dodi
Department of Obstetrics and Gynecology, Universitas Padjadjaran, Bandung, Indonesia.
Department of Obstetrics and Gynecology, Universitas Hasanuddin, Makassar, Indonesia.
Int J Womens Health. 2025 Apr 30;17:1193-1201. doi: 10.2147/IJWH.S496137. eCollection 2025.
Tumor markers such as CA125 are highly beneficial in predictive ovarian malignancy; however, this advanced test is not always available in remote areas. To address this issue, the author aimed to explore the use of systemic inflammatory biomarkers as complementary modalities for diagnosis of ovarian malignancy.
This diagnostic study utilized a cross-sectional approach, with outcomes measured by AUC and sensitivity. A total of 132 patients with adnexal tumors were consecutively included and measured a complete blood count. From this, the MLR (Monocyte Lymphocyte Ratio), NLR (Neutrophil Lymphocyte Ratio), PLR (Platelet Lymphocyte Ratio), SII (Systemic Immune Inflammation Index), and SIRI (Systemic Inflammatory Response Index) biomarkers were calculated. After surgery, histopathological examination was performed as the gold standard and the biomarker predictions were then compared to it, followed by statistical analysis.
The AUC values for MLR, NLR, PLR, SII, and SIRI were 0.70, 0.731, 0.696, 0.743, and 0.722, respectively. The p-values were MLR (0.005), NLR (0.001), PLR (0.001), SII (<0.001), and SIRI (<0.001), respectively. In multivariate analysis, only SII was significant (p = 0.015). The Exp(B) and 95% CI were 5.472 (1.383-21.655). The validity test for SII showed satisfactory results: sensitivity 71.64%, specificity 73.84%, PPV 73.84%, NPV 71.64%, accuracy 72.72%, LR+ 2.74%, and LR- 0.38%.
Systemic inflammatory biomarkers, particularly SII may aid in the predictive markers of early ovarian with diagnostic values nearly as good as CA125 (sensitivity 71.64% vs 75.97%). These biomarkers can serve as complementary predictive markes modalities for ovarian malignancy, especially when advanced tumor marker tests like CA125 are not available in remote areas.
CA125等肿瘤标志物在预测卵巢恶性肿瘤方面非常有用；然而，这种先进的检测方法在偏远地区并不总是能够获得。为了解决这个问题，作者旨在探索使用全身炎症生物标志物作为诊断卵巢恶性肿瘤的补充手段。
这项诊断性研究采用横断面研究方法，结果通过AUC和敏感性来衡量。总共连续纳入了132例附件肿瘤患者，并进行了全血细胞计数。由此计算出MLR（单核细胞淋巴细胞比率）、NLR（中性粒细胞淋巴细胞比率）、PLR（血小板淋巴细胞比率）、SII（全身免疫炎症指数）和SIRI（全身炎症反应指数）生物标志物。手术后，以组织病理学检查作为金标准，然后将生物标志物预测结果与之进行比较，随后进行统计分析。
MLR、NLR、PLR、SII和SIRI的AUC值分别为0.70、0.731、0.696、0.743和0.722。p值分别为MLR（0.005）、NLR（0.001）、PLR（0.001）、SII（<0.001）和SIRI（<0.001）。在多变量分析中，只有SII具有显著性（p = 0.015）。Exp(B)和95%CI为5.472（1.383 - 21.655）。SII的有效性测试显示结果令人满意：敏感性71.64%，特异性73.84%，PPV 73.84%，NPV 71.64%，准确性72.72%，LR+ 2.74%，LR - 0.38%。
全身炎症生物标志物，特别是SII，可能有助于早期卵巢癌的预测，其诊断价值几乎与CA125相当（敏感性71.64%对75.97%）。这些生物标志物可作为卵巢恶性肿瘤的补充预测标志物手段，特别是在偏远地区无法获得CA125等先进肿瘤标志物检测时。
