Comparison of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios with epithelial ovarian cancer stages

Year 2024, Volume: 10 Issue: 1 - January 2024, 37 - 44, 04.01.2024

Halil İbrahim Tıraş , Yakup Dülgeroğlu , Çetin Aydın

https://doi.org/10.18621/eurj.1308975

Abstract

Objectives: Epithelial ovarian cancer (EOC) is the most common histologic type among ovarian cancers. It is usually diagnosed at an advanced stage and the prognosis worsens. The aim of our study was to investigate the predictive value of serum platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR), which are systemic inflammatory response markers in EOC stages.

Methods: In this study, 140 patients diagnosed with primary EOC in İzmir Katip Çelebi University Atatürk Training and Research Hospital Gynecology and Obstetrics Clinic between 01.01.2012-01.07.2019 were included. The cases were staged using the FIGO 2014 Ovarian Cancer Staging system. Whether the PLR and NLR values were different between the stages were analyzed with appropriate statistical analysis methods.

Results: A total of 140 patients, 54 were in the early stage (Stage I: 47; Stage II: 7) and 86 were in the advanced stage (Stage III: 73; Stage IV: 13). The PLR and NLR values differed between the four stages (p = 0.003 and p = 0.032, respectively). The PLR value was different between the early and advanced stages (p = 0.033), the AUC value was 0.607, the optimum cut-off was 220, the sensitivity was 47%, and the specificity was 81% in the early and advanced stage discrimination. Accordingly, the Odds ratio of PLR for advanced EOC was 3.82 (95% CI: 1.70-8.57, p = 0.0011).

Conclusions: The NLR and PLR values were found to have a prognostic value in the discrimination of EOC stages. It has been determined that PLR value may play a predictive role in advanced EOC before surgery.

Keywords

Epithelial ovarian cancer, stage, prognosis, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio

References

• 1. Matulonis UA, Sood AK, Fallowfield L, Howitt BE, Sehouli J, Karlan BY. Ovarian cancer. Nat Rev Dis Primers. 2016;2:16061. doi: 10.1038/nrdp.2016.61.
• 2. Mathis J, Jellouli MA, Sabiani L, Fest J, Blache G, Mathevet P. Ovarian cancer screening in the general population. Horm Mol Biol Clin Investig. 2019;41(3). doi: 10.1515/hmbci-2019-0038.
• 3. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-249. doi: 10.3322/caac.21660.
• 4. Torre LA, Trabert B, DeSantis CE, et al. Ovarian cancer statistics, 2018. CA Cancer J Clin. 2018;68(4):284-296. doi: 10.3322/caac.21456.
• 5. Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883-899. doi: 10.1016/j.cell.2010.01.025.
• 6. Liu Y, Chen S, Zheng C, Ding M, et al. The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer. BMC Cancer. 2017;17(1):285. doi: 10.1186/s12885-017-3220-x.
• 7. Chen L, Wang X, Shu J, Xu S, Wu Q, Yu Y. Diagnostic value of serum D-dimer, CA125, and neutrophil-to-lymphocyte ratio in differentiating ovarian cancer and endometriosis. Int J Gynaecol Obstet. 2019;147(2):212-218. doi: 10.1002/ijgo.12949.
• 8. Li L, Tian J, Zhang L, et al. Utility of Preoperative Inflammatory Markers to Distinguish Epithelial Ovarian Cancer from Benign Ovarian Masses. J Cancer. 2021;12(9):2687-2693. doi: 10.7150/jca.51642.
• 9. Prat J; FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. 2014;124(1):1-5. doi: 10.1016/j.ijgo.2013.10.001.
• 10. Prodromidou A, Andreakos P, Kazakos C, Vlachos DE, Perrea D, Pergialiotis V. The diagnostic efficacy of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in ovarian cancer. Inflamm Res. 2017;66(6):467-475. doi: 10.1007/s00011-017-1026-6.
• 11. Ashrafganjoei T, Mohamadianamiri M, Farzaneh F, Hosseini MS, Arab M. Investigating preoperative hematologic markers for prediction of ovarian cancer surgical outcome. Asian Pac J Cancer Prev. 2016;17(3):1445-1448. doi: 10.7314/apjcp.2016.17.3.1445.
• 12. Kokcu A, Kurtoglu E, Celik H, Tosun M, Malatyalıoglu E, Ozdemir AZ. May the platelet to lymphocyte ratio be a prognostic factor for epithelial ovarian cancer? Asian Pac J Cancer Prev. 2014;15(22):9781-9784. doi: 10.7314/apjcp.2014.15.22.9781.
• 13. Zhang WW, Liu KJ, Hu GL, Liang WJ. Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients. Tumour Biol. 2015;36(11):8831-8837. doi: 10.1007/s13277-015-3533-9.
• 14. Huang K, Xu S, Wang J, Ge L, Xu J, Jia X. Combined use of CA125, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio for the diagnosis of borderline and malignant epithelial ovarian tumors. J Ovarian Res. 2023;16(1):37. doi: 10.1186/s13048-023-01106-4.
• 15. Wang Y, Liu P, Xu Y, et al. Preoperative neutrophil-to-lymphocyte ratio predicts response to first-line platinum-based chemotherapy and prognosis in serous ovarian cancer. Cancer Chemother Pharmacol. 2015;75(2):255-262. doi: 10.1007/s00280-014-2622-6.
• 16. Polat M, Senol T, Ozkaya E, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratios increase in ovarian tumors in the presence of frank stromal invasion. Clin Transl Oncol. 2016;18(5):457-463. doi: 10.1007/s12094-015-1387-7.
• 17. Yildirim MA, Seckin KD, Togrul C, et al. Roles of neutrophil/lymphocyte and platelet/lymphocyte ratios in the early diagnosis of malignant ovarian masses. Asian Pac J Cancer Prev. 2014;15(16):6881-6885. doi: 10.7314/apjcp.2014.15.16.6881.
• 18. Bakacak M, Serin S, Ercan Ö, et al. Utility of preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios to distinguish malignant from benign ovarian masses. J Turk Ger Gynecol Assoc. 2016;17(1):21-25. doi: 10.5152/jtgga.2015.0152.
• 19. Zhao Z, Zhao X, Lu J, Xue J, Liu P, Mao H. Prognostic roles of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in ovarian cancer: a meta-analysis of retrospective studies. Arch Gynecol Obstet. 2018;297(4):849-857. doi: 10.1007/s00404-018-4678-8.