MEAN PLATELET VOLUME, NEUTROPHIL TO LYMPHOCTE RATIO, AND PLATELET TO LYMPHOCTE RATIO FOR DIFFERENTIATING BENIGN, BORDERLINE AND MALIGNANT OVARIAN MASSES

Abstract

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) have been gaining attention as systemic inflammatory response and angiogenetic markers. OBJECTIVE: We assessed the utility of NLR, PLR and MPV as preoperative inflammatory markers, to better distinguish malignant from benign and borderline ovarian tumors. METHODS: Retrospective designed study performed in the gynecology department of an university clinic. Patients who underwent surgery due to suspected pelvic mass enrolled the study group. Patients were divided into three groups as benign, borderline, and malignant cases according to final histopathologic results. Patients’ preoperative NLR, PLR and MPV counts were compared. RESULTS: MPV, NLR and PLR were found to significantly higher in patients with malignant adnexal mass, however there were no difference among MPV, NLR and PLR in patients with benign and borderline ovarian tumor. Cut of values for MPV, NLR and PLR were calculated as 8.4, 3.5, and 149473 respectively to predict malignancy (p<0.001, p<0.01, p<0.001) CONCLUSIONS: Assessing the role of NLR, PLR, and MPV in patients with adnexal mass might be of clinical usefulness, especially in predicting malignant disease. MPV was found to be the strongest parameter to predict malignancy among CBC parameters.

Keywords

• MPV
• ovarian mass
• benign
• borderline
• malignant

References

1. 1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin 59 (2009), 225-249.
2. 2. Wei SH, Chen CM, Strathdee G, Harnsomburana J, Shyu CR, Rahmatpanah F, et al. Methylation microarray analysis of late-stage ovarian carcinomas distinguishes progression-free survival in patients and identifies candidate epigenetic markers. Clin Cancer Res 8 (2002), 2246-2252. 

3. 3. Romagnolo C, Leon AE, Fabricio AS, Taborelli M, Polesel J, Del Pup L, Steffan A, Cervo S, Ravaggi A, Zanotti L, Bandiera E, Odicino FE, Scattolo N, Squarcina E, Papadakis C, Maggino T, Gion M. HE4, CA125 and risk of ovarian malignancy algorithm (ROMA) as diagnostic tools for ovarian cancer in patients with a pelvic mass: An Italian multicenter study. Gynecol Oncol 141 (2016), 303-311.
4. 4. Yanaranop M, Tiyayon J, Siricharoenthai S, Nakrangsee S, Thinkhamrop B. Rajavithi-ovarian cancer predictive score (R-OPS): A new scoring system for predicting ovarian malignancy in women presenting with a pelvic mass. Gynecol Oncol 141 (2016), 479-484.
5. 5. Timmerman D, Van Calster B, Testa A, Savelli L, Fischerova D, Froyman W, Wynants L, Van Holsbeke C, Epstein E, Franchi D, Kaijser J, Czekierdowski A, Guerriero S, Fruscio R, Leone FP, Rossi A, Landolfo C, Vergote I, Bourne T, Valentin L. Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis group. Am J Obstet Gynecol 214(4) (2016), 424-437.
6. 6. Haemmerle M, Stone RL, Menter DG, Afshar-Kharghan V, Sood AK. The Platelet Lifeline to Cancer: Challenges and Opportunities. Cancer Cell 33(6) (2018), 965-983.
7. 7. Oge T, Yalcin OT, Ozalp SS, Isikci T. Platelet volume as a parameter for platelet activation in patients with endometrial cancer. J Obstet Gynaecol 33(3) (2013), 301-304.
8. 8. Baert T, Van Camp J, Vanbrabant L, Busschaert P, Laenen A, Han S, Van Nieuwenhuysen E, Vergote I, Coosemans A. Influence of CA125, platelet count and neutrophil to lymphocyte ratio on the immune system of ovarian cancer patients. Gynecol Oncol 150(1) (2018), 31-37.

9. 9. Williams KA, Labidi-Galy SI, Terry KL, Vitonis AF, Welch WR, Goodman A, et al. Prognostic significance and predictors of the neutrophil-to-lymphocyte ratio in ovarian cancer. Gynecol Oncol 132 (2014), 542-550. 

10. 10. Temur I, Kucukgoz Gulec U, Paydas S, Guzel AB, Sucu M, Vardar MA. Prognostic value of pre-operative neutrophil/lymphocyte ratio, monocyte count, mean platelet volume, and platelet/lymphocyte ratio in endometrial cancer Eur J Obstet Gynecol Reprod Biol 226 (2018), 25-29.
11. 11. Yilmaz E, Coskun EI, Sahin N, Ciplak B, Ekici K. MPV, NLR, and platelet count: new hematologic markers in diagnosis of malignant ovarian tumor. Eur J Gynaecol Oncol 38(3) (2017), 346-349.
12. 12. Ethier JL, Desautels DN, Templeton AJ, Oza A, Amir E, Lheureux S. Is the neutrophil-to-lymphocyte ratio prognostic of survival outcomes in gynecologic cancers? A systematic review and meta-analysis. Gynecol Oncol. 145(3) (2017), 584-594.
13. 13. Seckin KD, Karslı MF, Yucel B, Bestel M, Yıldırım D, Canaz E, Akbayır O. The utility of tumor markers and neutrophil lymphocyte ratio in patients with an intraoperative diagnosis of mucinous borderline ovarian tumor. Eur J Obstet Gynecol Reprod Biol 196 (2016) 60-63.
14. 14. Khatib G, Soysal C, Çetin C, Güleç ÜK, Güzel AB, Keskin N, Vardar MA, Gümürdülü D. Does preoperative neutrophil to lymphocyte or platelet to lymphocyte ratios have a role in predicting borderline ovarian tumors? J Ovarian Res 9(1) (2016), 78.
15. 15. Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell 140 (2010), 883– 899.
16. 16. Pergialiotis V, Oikonomou M, Damaskou V, Kalantzis D, Chrelias C, Tsantes AE, Panayiotides I. Platelet to lymphocyte and neutrophil to lymphocyte ratio as predictive indices of endometrial carcinoma: Findings from a retrospective series of patients and meta-analysis. J Gynecol Obstet Hum Reprod 2018 pii: S2468-7847(18)30263-0. doi: 10.1016/j.jogoh.2018.08.016
17. 17. Marchetti C, Romito A, Musella A, Santo G, Palaia I, Perniola G, Di Donato V, Muzii L, Benedetti Panici P. Combined Plasma Fibrinogen and Neutrophil Lymphocyte Ratio in Ovarian Cancer Prognosis May Play a Role? Int J Gynecol Cancer 28(5) (2018), 939-944.
18. 18. 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 297(4) (2018), 849-857.
19. 19. Eo WK, Kim KH, Park EJ, Kim HY, Kim HB, Koh SB, Namkung J. Diagnostic accuracy of inflammatory markers for distinguishing malignant and benign ovarian masses. J Cancer. 9(7) (2018), 1165-1172.
20. 20. Yildirim M, Demir Cendek B, Filiz Avsar A. Differentiation between benign and malignant ovarian masses in the preoperative period using neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios. Mol Clin Oncol 3(2) 2015, 317-321.