Research Article
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Year 2020, Volume: 6 Issue: 2, 111 - 119, 04.03.2020
https://doi.org/10.18621/eurj.483442

Abstract

References

  • 1. Strauss JF, Barbieri RL. Yen & Jaffe's Reproductive Endocrinology E-Book: Physiology, Pathophysiology, and Clinical Management. Elsevier Health Sciences. 2013.
  • 2. Raffi F, Metwally M, Amer S. The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab 2012;97:3146-54.
  • 3. Tanbo T, Fedorcsak P. Endometriosis‐associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obstet Gynecol Scand 2017;96:659-67.
  • 4. Clement PB. The pathology of endometriosis: a survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects. Adv Anat Pathol 2007;14:241-60.
  • 5. Tsoumpou I, Kyrgiou M, Gelbaya TA, Nardo LG. The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis. Fertil Steril 2009;92:75-87.
  • 6. Somigliana E, Berlanda N, Benaglia L, Viganò P, Vercellini P, Fedele L. Surgical excision of endometriomas and ovarian reserve: a systematic review on serum antimüllerian hormone level modifications. Fertil Steril 2012;98:1531-8.
  • 7. Guerriero S, Mais V, Ajossa S, Paoletti AM, Angiolucci M, Melis GB. Transvaginal ultrasonography combined with CA-125 plasma levels in the diagnosis of endometrioma. Fertil Steril 1996;65:293-8.
  • 8. May KE, Conduit-Hulbert SA, Villar J, Kirtley S, Kennedy SH, Becker CM. Peripheral biomarkers of endometriosis: a systematic review. Hum Reprod Update 2010;16:651-74.
  • 9. Fassbender A, Dorien O, De Moor B, Waelkens E, Meuleman C, Tomassetti C, et al. Biomarkers of endometriosis. In: Endometriosis. Springer, Tokyo. 2014:pp. 321-39.
  • 10. Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther 2001;69:89-95.
  • 11. Knific T, Vouk K, Vogler A, Osredkar J, Gstöttner M, Wenzl R, et al. Models including serum CA-125, BMI, cyst pathology, dysmenorrhea or dyspareunia for diagnosis of endometriosis. Biomark Med 2018;12:737-47.
  • 12. Hirsch M, Duffy JM, Deguara CS, Davis CJ, Khan KS. Diagnostic accuracy of Cancer Antigen 125 (CA125) for endometriosis in symptomatic women: a multi-center study. Eur J Obstet Gynecol Reprod Biol 2017;210:102-7.
  • 13. Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 2014;106:dju124
  • 14. Kajihara H, Yamada Y, Kanayama S, Furukawa N, Noguchi T, Haruta S, et al. New insights into the pathophysiology of endometriosis: from chronic inflammation to danger signal. Gynecol Endocrinol 2011;27:73-9.
  • 15. Cho S, Cho H, Nam A, Kim HY, Choi YS, Park KH, et al. Neutrophil-to-lymphocyte ratio as an adjunct to CA-125 for the diagnosis of endometriosis. Fertil Steril 2008;90:2073-9.
  • 16. Sayan CD, Özakşit MG, Sarikaya E, Eryılmaz ÖG, Mollamahmutoğlu L, Deveer R. Serum interleukin-8, CA-125 levels, neutrophil-to-lymphocyte ratios, and combined markers in the diagnosis of endometriosis. Turk J Med Sci 2013;43:417-23.
  • 17. Yang H, Lang JH, Zhu L, Wang S, Sha GH, Zhang Y. Diagnostic value of the neutrophil-to-lymphocyte ratio and the combination of serum CA-125 for stages III and IV endometriosis. Chin Med J 2013;126:2011-14.
  • 18. Kim SK, Park JY, Jee BC, Suh CS, Kim SH. Association of the neutrophil-to-lymphocyte ratio and CA-125 with the endometriosis score. Clin Exp Reprod Med 2014;41:151-7.
  • 19. Yavuzcan A, Çağlar M, Üstün Y, Dilbaz S, Özdemir İ, Yıldız E, et al. Evaluation of mean platelet volume, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in advanced stage endometriosis with endometrioma. J Turk Ger Gynecol Assoc 2013;14:210-5.
  • 20. Surya IU, Harzif AK, Maidarti M, Pratama G, Wiweko B. Expression of CA-125 level and neutrophil to lymphocyte ratio in infected and non-infected endometrioma. KnE Medicine 2017;1:173-9.
  • 21. Yildirim MA, Seckin KD, Togrul C, Baser E, Karsli MF, Gungor T, et al. Roles of neutrophil/lymphocyte and platelet/lymphocyte ratios in the early diagnosis of malignant ovarian masses. Asian Pac J Cancer Prev 2014;15:6881-5.
  • 22. Topcu HO, Guzel AI, Ozer I, Kokanali MK, Gokturk U, Muftuoglu KH, et al. Comparison of neutrophil/lymphocyte and platelet/lymphocyte ratios for predicting malignant potential of suspicious ovarian masses in gynecology practice. Asian Pac J Cancer Prev 2014;15:6239-41.
  • 23. Osuga Y, Koga K, Hirota Y, Hirata T, Yoshino O, Taketani Y. Lymphocytes in endometriosis. Am J Reprod Immunol 2011;65:1-10.
  • 24. Yang H, Zhu L, Wang S, Lang J, Xu T. Noninvasive diagnosis of moderate to severe endometriosis: the platelet-lymphocyte ratio cannot be a neoadjuvant biomarker for serum cancer antigen 125. J Minim Invasive Gynecol 2015;22:373-7.
  • 25. Tokmak A, Yildirim G, Öztaş E, Akar S, Erkenekli K, Gülşen P, et al. Use of neutrophil-to-lymphocyte ratio combined with CA-125 to distinguish endometriomas from other benign ovarian cysts. Reprod Sci 2016;23:795-802.
  • 26. Kucur SK, Seven A, Yuksel KB, Sencan H, Gozukara I, Keskin N. Mean platelet volume, a novel biomarker in adolescents with severe primary dysmenorrhea. J Pediatr Adolesc Gynecol 2016;29:390-2.
  • 27. Maiorana A, Cicerone C, Niceta M, Alio L. Evaluation of serum CA 125 levels in patients with pelvic pain related to endometriosis. Int J Biol Markers 2007;22:200-2.
  • 28. Jiang C, Liu C, Guo J, Chen L, Luo N, Qu X, et al. CA125 modified by PLT and NLR improves the predictive accuracy of adenomyosis-derived pelvic dense adhesion. Medicine (Baltimore) 2017;96:e6880.

The additional diagnostic value of NLR and PLR for CA-125 in the differential diagnosis of endometrioma and benign ovarian cysts in women of reproductive age: a retrospective case-control study

Year 2020, Volume: 6 Issue: 2, 111 - 119, 04.03.2020
https://doi.org/10.18621/eurj.483442

Abstract

Objectives:
Aim of this study is to investigate
the diagnostic value of neutrophil/lymphocyte ratio (NLR) and
platelet/lymphocyte ratio (PLR) for cancer antigen-125 (CA-125) in a differential
diagnosis of endometrioma from benign ovarian cysts.

Methods: In this retrospective study, the medical data of a total of 213 patients
aged < 40 years who underwent laparoscopic or laparotomic surgery for
ovarian cysts between April 2015 and June 2018 were analyzed. The patients were
divided into two groups, as those with endometriomas and those with other benign
ovarian cysts, all which had been confirmed histopathologically. Data on age,
body mass index (BMI), preoperative US findings, complete blood count analysis
results, follicle-stimulating hormone (FSH) levels, and the presence of
dysmenorrhea, dyspareunia and chronic pelvic pain were recorded.

Results: NLR, PLR and CA-125 were increased in the patients with endometrioma,
although increases in the NLR and PLR alone or combined did not contribute to
the sensitivity or specificity of CA-125.







Conclusions: The results of our study suggest that NLR and PLR did not contribute to
the diagnostic value of CA-125 in the preoperative differential diagnosis of
endometriomas or other benign ovarian cysts. In addition, CA-125 was not
associated with clinical symptoms, although a relationship was identified between
NLR and dysmenorrhea, and between PLR and lesion size, which may be the
research focus of further studies. 

References

  • 1. Strauss JF, Barbieri RL. Yen & Jaffe's Reproductive Endocrinology E-Book: Physiology, Pathophysiology, and Clinical Management. Elsevier Health Sciences. 2013.
  • 2. Raffi F, Metwally M, Amer S. The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab 2012;97:3146-54.
  • 3. Tanbo T, Fedorcsak P. Endometriosis‐associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obstet Gynecol Scand 2017;96:659-67.
  • 4. Clement PB. The pathology of endometriosis: a survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects. Adv Anat Pathol 2007;14:241-60.
  • 5. Tsoumpou I, Kyrgiou M, Gelbaya TA, Nardo LG. The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis. Fertil Steril 2009;92:75-87.
  • 6. Somigliana E, Berlanda N, Benaglia L, Viganò P, Vercellini P, Fedele L. Surgical excision of endometriomas and ovarian reserve: a systematic review on serum antimüllerian hormone level modifications. Fertil Steril 2012;98:1531-8.
  • 7. Guerriero S, Mais V, Ajossa S, Paoletti AM, Angiolucci M, Melis GB. Transvaginal ultrasonography combined with CA-125 plasma levels in the diagnosis of endometrioma. Fertil Steril 1996;65:293-8.
  • 8. May KE, Conduit-Hulbert SA, Villar J, Kirtley S, Kennedy SH, Becker CM. Peripheral biomarkers of endometriosis: a systematic review. Hum Reprod Update 2010;16:651-74.
  • 9. Fassbender A, Dorien O, De Moor B, Waelkens E, Meuleman C, Tomassetti C, et al. Biomarkers of endometriosis. In: Endometriosis. Springer, Tokyo. 2014:pp. 321-39.
  • 10. Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther 2001;69:89-95.
  • 11. Knific T, Vouk K, Vogler A, Osredkar J, Gstöttner M, Wenzl R, et al. Models including serum CA-125, BMI, cyst pathology, dysmenorrhea or dyspareunia for diagnosis of endometriosis. Biomark Med 2018;12:737-47.
  • 12. Hirsch M, Duffy JM, Deguara CS, Davis CJ, Khan KS. Diagnostic accuracy of Cancer Antigen 125 (CA125) for endometriosis in symptomatic women: a multi-center study. Eur J Obstet Gynecol Reprod Biol 2017;210:102-7.
  • 13. Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 2014;106:dju124
  • 14. Kajihara H, Yamada Y, Kanayama S, Furukawa N, Noguchi T, Haruta S, et al. New insights into the pathophysiology of endometriosis: from chronic inflammation to danger signal. Gynecol Endocrinol 2011;27:73-9.
  • 15. Cho S, Cho H, Nam A, Kim HY, Choi YS, Park KH, et al. Neutrophil-to-lymphocyte ratio as an adjunct to CA-125 for the diagnosis of endometriosis. Fertil Steril 2008;90:2073-9.
  • 16. Sayan CD, Özakşit MG, Sarikaya E, Eryılmaz ÖG, Mollamahmutoğlu L, Deveer R. Serum interleukin-8, CA-125 levels, neutrophil-to-lymphocyte ratios, and combined markers in the diagnosis of endometriosis. Turk J Med Sci 2013;43:417-23.
  • 17. Yang H, Lang JH, Zhu L, Wang S, Sha GH, Zhang Y. Diagnostic value of the neutrophil-to-lymphocyte ratio and the combination of serum CA-125 for stages III and IV endometriosis. Chin Med J 2013;126:2011-14.
  • 18. Kim SK, Park JY, Jee BC, Suh CS, Kim SH. Association of the neutrophil-to-lymphocyte ratio and CA-125 with the endometriosis score. Clin Exp Reprod Med 2014;41:151-7.
  • 19. Yavuzcan A, Çağlar M, Üstün Y, Dilbaz S, Özdemir İ, Yıldız E, et al. Evaluation of mean platelet volume, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in advanced stage endometriosis with endometrioma. J Turk Ger Gynecol Assoc 2013;14:210-5.
  • 20. Surya IU, Harzif AK, Maidarti M, Pratama G, Wiweko B. Expression of CA-125 level and neutrophil to lymphocyte ratio in infected and non-infected endometrioma. KnE Medicine 2017;1:173-9.
  • 21. Yildirim MA, Seckin KD, Togrul C, Baser E, Karsli MF, Gungor T, et al. Roles of neutrophil/lymphocyte and platelet/lymphocyte ratios in the early diagnosis of malignant ovarian masses. Asian Pac J Cancer Prev 2014;15:6881-5.
  • 22. Topcu HO, Guzel AI, Ozer I, Kokanali MK, Gokturk U, Muftuoglu KH, et al. Comparison of neutrophil/lymphocyte and platelet/lymphocyte ratios for predicting malignant potential of suspicious ovarian masses in gynecology practice. Asian Pac J Cancer Prev 2014;15:6239-41.
  • 23. Osuga Y, Koga K, Hirota Y, Hirata T, Yoshino O, Taketani Y. Lymphocytes in endometriosis. Am J Reprod Immunol 2011;65:1-10.
  • 24. Yang H, Zhu L, Wang S, Lang J, Xu T. Noninvasive diagnosis of moderate to severe endometriosis: the platelet-lymphocyte ratio cannot be a neoadjuvant biomarker for serum cancer antigen 125. J Minim Invasive Gynecol 2015;22:373-7.
  • 25. Tokmak A, Yildirim G, Öztaş E, Akar S, Erkenekli K, Gülşen P, et al. Use of neutrophil-to-lymphocyte ratio combined with CA-125 to distinguish endometriomas from other benign ovarian cysts. Reprod Sci 2016;23:795-802.
  • 26. Kucur SK, Seven A, Yuksel KB, Sencan H, Gozukara I, Keskin N. Mean platelet volume, a novel biomarker in adolescents with severe primary dysmenorrhea. J Pediatr Adolesc Gynecol 2016;29:390-2.
  • 27. Maiorana A, Cicerone C, Niceta M, Alio L. Evaluation of serum CA 125 levels in patients with pelvic pain related to endometriosis. Int J Biol Markers 2007;22:200-2.
  • 28. Jiang C, Liu C, Guo J, Chen L, Luo N, Qu X, et al. CA125 modified by PLT and NLR improves the predictive accuracy of adenomyosis-derived pelvic dense adhesion. Medicine (Baltimore) 2017;96:e6880.
There are 28 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Original Articles
Authors

Ziya Kalem 0000-0002-5435-2074

Çoşkun Şimşir This is me 0000-0003-1825-6584

Batuhan Bakırarar This is me 0000-0002-5662-8193

Müberra Namlı Kalem 0000-0002-2316-5495

Publication Date March 4, 2020
Submission Date November 15, 2018
Acceptance Date January 7, 2019
Published in Issue Year 2020 Volume: 6 Issue: 2

Cite

AMA Kalem Z, Şimşir Ç, Bakırarar B, Namlı Kalem M. The additional diagnostic value of NLR and PLR for CA-125 in the differential diagnosis of endometrioma and benign ovarian cysts in women of reproductive age: a retrospective case-control study. Eur Res J. March 2020;6(2):111-119. doi:10.18621/eurj.483442

e-ISSN: 2149-3189 


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