Can a complete blood count test predict coexisting adenocarcinoma in patients with atypical endometrial hyperplasia?

Abstract

To assess the role of inflammatory markers in preoperative prediction of a coexisting endometrial adenocarcinoma (EC) in patients with atypical endometrial hyperplasia (AEH). Patients with a preoperative diagnosis of AEH based on endometrial sampling and who underwent surgical treatment were retrospectively assessed. Ratios of platelet-to-lymphocyte, neutrophil-to-lymphocyte and lymphocyte-to-monocyte, systemic immune-inflammation index and systemic inflammation response index were calculated. Patients were grouped based on the definitive postoperative pathological diagnosis as benign and endometrial adenocarcinoma groups. The cell counts and inflammatory markers were compared between these two groups. ROC curves were constructed for independent predictors of the diagnosis of coexisting endometrial adenocarcinoma to establish diagnostic cut-off values. There were 54 patients. Coexisting EC was detected in 30 patients (55.6%). All of the adenocarcinomas were endometrioid adenocarcinomas in stage 1. Among components of complete blood count (CBC) test monocyte counts, nucleated red blood cell (NRBC) percentage and immature granulocyte (IG) percentage were found to be significantly higher in the adenocarcinoma group. No significant difference was observed with respect to the inflammation indices. ROC curve analysis was performed in order to find cut-off values for monocyte count, NRBC percentage and IG percentage with significant sensitivities and specificities to predict coexisting adenocarcinoma, however, none of these parameters reached a significant area under the curve value. Monocytes, NRBCs and IGs tend to rise in AEH patients with coexisting EH; however, in endometrial biopsy-based AEH diagnosed patients, the prediction of coexisting EC with a simple CBC seems not to be possible.

Keywords

• complete blood count
• atypical endometrial hyperplasia
• immature granulocyte
• monocyte
• inflammatory index
• endometrial adenocarcinoma

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