Predictive value of preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in predicting lymph node metastasis in endometrial cancer
Main Article Content
Keywords
Endometrial carcinoma, metastasis to lymph nodes, neutrophil to lymphocyte, platelet to lymphocyte ratio
Abstract
Background: Predicting lymph node metastasis in endometrial cancer patients is one of the most critical elements in assessing disease prognosis and selecting whether to undertake lymphadenectomy. There is limited and contradictory information about the predictive efficacy of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratio in predicting lymph node metastasis.The purpose of the present study was to evaluate the predictive efficacy of preoperative neutrophil and platelet-to-lymphocyte ratios for predicting lymph node metastases in endometrial cancer patients.
Materials and methods: This retrospective study was conducted on the medical records of endometrial carcinoma patients treated at Al-Zahra Hospital in Tabriz with gynecological cancers in between 2016 -2020. Demographic data including age, initial symptoms, history of cancer, chemotherapy, serum Cancer Antigen 125 (CA125) level, pre-operative level of complete blood count (CBC), white blood cells (WBCs), neutrophils, lymphocytes, monocytes, hemoglobin, curettage result, and cancer surgery stage were extracted from patient’s files. We utilized the receiver operating characteristic curve (ROC) to calculate the optimal value of the cut-off point for NLR and PLR. All analyses were conducted using Statistical Package for the Social Sciences (SPSS) 26.
Results: From the total of 131 participants, More than two third histopathological subtype was endometrioid endometrial carcinoma [73.0%]. The ROC curve revealed that the cut-off for NLR and PLR was 2.47 and 62.67, respectively. The rising trend of NLR is a prognostic marker for lymphatic metastasis, according to a logistic regression analysis [hazard ratio = 1.20; 95% [CI], 1.5-2.3; P = 0.001]. Although the rising trend of PLR was associated with an increased risk of lymph node metastasis, it has no significant predictive value in the present model P= 0.1]
Conclusion: The rising trend of NLR can be utilized as an independent predictor of lymphatic metastasis in women with endometrial cancer and can aid clinicians in pre-operative risk stratification and treatment strategy.
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