The relationship of pre-operative laboratory parameters with endometrial cancer and prognostic factors

Öz

Aim: In our study, we aimed to evaluate whether pre-operative complete blood count and biochemical parameters are related to some prognostic markers and stage of the disease in patients who underwent surgery for endometrial cancer. Materials and Methods: One hundred seventy-five patients diagnosed with endometrial cancer operated in our clinic between January 2017 and December 2019 were retrospectively studied. We analyzed complete blood count parameters include hemoglobin (Hb), white blood cell count, platelet count, neutrophil count, and percentage, lymphocyte number and percentage, mean corpuscular volume (MCV), mean platelet volume (MPV), red blood cell distribution width (RDW), and NLR, which is the division of the neutrophil count to the lymphocyte count, PLR, which is the division of the platelet count to the lymphocyte count and other biochemical parameters. Statistical methods investigated their relationship with prognostic parameters such as tumor diameter, tumor differentiation, tumor type, myometrial invasion, and FIGO stage. Results: There was a statistically significant increase according to age, Hb, RDW, lymphocyte percentage, and NLR (p<0.05) in terms of myometrial invasion degree. As the MPV increased, the tumor's differentiation increased significantly from grade 1 to grade 2 (p<0.05). We found a statistically significant difference between the stage of the disease and the values of age, Hb, RDW, lymphocyte percentage, alanine transaminase, and PLR (p<0.05). There was a significant difference between the Hb level and RDW and the pathological type of the tumor (endometrioid, non-endometrioid) among the laboratory parameters checked before the operation (p <0.05). Type 1 endometrial cancer patients were significantly younger than the type 2 group (p<0.05). Conclusion: The use of pre-operative complete blood count, liver and kidney enzyme parameters may provide an idea about the prognostic components and stage of the disease in patients with a diagnosis or suspicion of endometrial cancer.

Anahtar Kelimeler

• Endometrial Cancer
• Complete Blood Count
• Hemoglobin
• Lymphocyte
• Platelet

Kaynakça

1. 1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68:394–424.
2. 2. Smith RA, von Eschenbach AC, Wender R, Levin B, Byers T, Rothenberger D, et al. American Cancer Society Guidelines for the Early Detection of Cancer: Update of Early Detection Guidelines for Prostate, Colorectal, and Endometrial Cancers: ALSO: Update 2001—Testing for Early Lung Cancer Detection. CA: A Cancer Journal for Clinicians. 2001;51:38–75. doi: 10.3322/canjclin.51.1.38.
3. 3. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer. 2015;136:E359-86.
4. 4. Grivennikov SI, Greten FR, Karin M. Immunity, Inflammation, and Cancer. Cell. 2010;140:883–99. doi: 10.1016/j.cell.2010.01.025.
5. 5. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? The Lancet. 2001;357:539–45. doi: 10.1016/S0140-6736(00)04046-0.
6. 6. Roxburgh CSD, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncology. 2010;6:149–63.
7. 7. Li MX, Liu XM, Zhang XF, Zhang JF, Wang WL, Zhu Y, et al. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: A systematic review and meta-analysis. International Journal of Cancer. 2014;134:2403–13.
8. 8. Tan D, Fu Y, Su Q, Wang H. Prognostic role of platelet–lymphocyte ratio in colorectal cancer. Medicine. 2016;95:e3837.

9. 9. Paramanathan A, Saxena A, Morris DL. A systematic review and meta-analysis on the impact of pre-operative neutrophil-lymphocyte ratio on long term outcomes after curative intent resection of solid tumours. Surgical Oncology. 2014;23:31–9. doi: 10.1016/j.suronc.2013.12.001.
10. 10. Ethier J-L, 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. Gynecologic Oncology. 2017;145:584–94. doi: 10.1016/j.ygyno.2017.02.026.
11. 11. 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. JNCI: Journal of the National Cancer Institute. 2014;106. doi: 10.1093/jnci/dju124.
12. 12. Cummings M, Merone L, Keeble C, Burland L, Grzelinski M, Sutton K, et al. Pre-operative neutrophil:lymphocyte and platelet:lymphocyte ratios predict endometrial cancer survival. British Journal of Cancer. 2015;113:311–20. doi: 10.1038/bjc.2015.200.
13. 13. Acmaz G, Aksoy H, Unal D, Ozyurt S, Cingillioglu B, Aksoy U, et al. Are neutrophil/lymphocyte and platelet/lymphocyte ratios associated with endometrial precancerous and cancerous lesions in patients with abnormal uterine bleeding? Asian Pacific journal of cancer prevention : APJCP. 2014;15:1689–92.
14. 14. Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012;23:265–73.
15. 15. Pergialiotis V, Oikonomou M, Damaskou V, Kalantzis D, Chrelias C, Tsantes AE, et al. Platelet to lymphocyte and neutrophil to lymphocyte ratio as predictive indices of endometrial carcinoma: Findings from a retrospective series of patients and meta-analysis. Journal of Gynecology Obstetrics and Human Reproduction. 2018;47:511–6. doi: 10.1016/j.jogoh.2018.08.016.
16. 16. Peng H-X, Lin K, He B-S, Pan Y-Q, Ying H-Q, Hu X-X, et al. Platelet-to-lymphocyte ratio could be a promising prognostic biomarker for survival of colorectal cancer: a systematic review and meta-analysis. FEBS Open Bio. 2016;6:742–50. doi: 10.1002/2211-5463.12083.
17. 17. Li AJ, Madden AC, Cass I, Leuchter RS, Lagasse LD, Karlan BY. The prognostic significance of thrombocytosis in epithelial ovarian carcinoma. Gynecologic Oncology. 2004;92:211–4. doi: 10.1016/j.ygyno.2003.09.002.
18. 18. Tomita M, Shimizu T, Hara M, Ayabe T, Onitsuka T. Prognostic impact of thrombocytosis in resectable non-small cell lung cancer. Interactive CardioVascular and Thoracic Surgery. 2008;7:613–5. doi: 10.1510/icvts.2007.174391.
19. 19. Yamamoto M, Kurokawa Y, Kobayashi N, Takahashi T, Miyazaki Y, Tanaka K, et al. Prognostic Value of the Combined Index of Plasma Fibrinogen and the Neutrophil–Lymphocyte Ratio in Gastric Cancer. World Journal of Surgery. 2020;44:207–12. doi: 10.1007/s00268-019-05193-7.
20. 20. Zhao LY, Zhao YL, Wang JJ, Zhao Q Di, Yi WQ, Yuan Q, et al. Is Pre-operative Fibrinogen Associated with the Survival Prognosis of Gastric Cancer Patients? A Multi-centered, Propensity Score-Matched Retrospective Study. World Journal of Surgery. 2020;44:213–22. doi: 10.1007/s00268-019-05191-9.
21. 21. Perisanidis C, Psyrri A, Cohen EE, Engelmann J, Heinze G, Perisanidis B, et al. Prognostic role of pretreatment plasma fibrinogen in patients with solid tumors: A systematic review and meta-analysis. Cancer Treatment Reviews. 2015;41:960–70. doi: 10.1016/j.ctrv.2015.10.002.
22. 22. Davalos D, Akassoglou K. Fibrinogen as a key regulator of inflammation in disease. Seminars in Immunopathology. 2012;34:43–62. doi: 10.1007/s00281-011-0290-8.
23. 23. Bokhman J V. Two pathogenetic types of endometrial carcinoma. Gynecologic oncology. 1983;15:10–7.
24. 24. Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140:883–99.
25. 25. Greten FR, Grivennikov SI. Inflammation and Cancer: Triggers, Mechanisms, and Consequences. Immunity. 2019;51:27–41. doi: 10.1016/j.immuni.2019.06.025.
26. 26. Singh N, Baby D, Rajguru JP, Patil PB, Thakkannavar SS, Pujari VB. Inflammation and cancer. Annals of African medicine. 2019;18:121–6.
27. 27. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420:860–7.
28. 28. Dossus L, Rinaldi S, Becker S, Lukanova A, Tjonneland A, Olsen A, et al. Obesity, inflammatory markers, and endometrial cancer risk: a prospective case-control study. Endocrine-related cancer. 2010;17:1007–19.
29. 29. Zhao Y, Nichols JE, Bulun SE, Mendelson CR, Simpson ER. Aromatase P450 Gene Expression in Human Adipose Tissue. ROLE OF A Jak/STAT PATHWAY IN REGULATION OF THE ADIPOSE-SPECIFIC PROMOTER *. Journal of Biological Chemistry. 1995;270:16449–57. doi: 10.1074/jbc.270.27.16449.
30. 30. Ekici H, Malatyalioglu E, Kokcu A, Kurtoglu E, Tosun M, Celik H. Do Leukocyte and Platelet Counts Have Benefit for\Pre-operative Evaluation of Endometrial Cancer? Asian Pacific Journal of Cancer Prevention. 2015;16:5305–10.
31. 31. Karateke A, Kaplanoglu M, Baloglu A. Relations of platelet indices with endometrial hyperplasia and endometrial cancer. Asian Pacific Journal of Cancer Prevention. 2015;16:4905–8.
32. 32. Oge T, Yalcin OT, Ozalp SS, Isikci T. Platelet volume as a parameter for platelet activation in patients with endometrial cancer. Journal of Obstetrics and Gynaecology. 2013;33:301–4.
33. 33. Takahashi R, Mabuchi S, Kawano M, Sasano T, Matsumoto Y, Kuroda H, et al. Prognostic significance of systemic neutrophil and leukocyte alterations in surgically treated endometrial cancer patients: a monoinstitutional study. Gynecologic oncology. 2015;137:112–8.
34. 34. Kemal Y, Demirag G, Baş B, Önem S, Teker F, Yücel İ. The value of red blood cell distribution width in endometrial cancer. Clinical Chemistry and Laboratory Medicine (CCLM). 2015;53:823–7.
35. 35. Takahashi R, Mabuchi S, Kuroda H, Kozasa K, Yokoi E, Matsumoto Y, et al. The Significance of Pretreatment Thrombocytosis and Its Association With Neutrophilia in Patients With Surgically Treated Endometrial Cancer. International Journal of Gynecologic Cancer. 2017;27:1399 LP – 1407. doi: 10.1097/IGC.0000000000001019.
36. 36. Luomaranta A, Leminen A, Loukovaara M. Prediction of lymph node and distant metastasis in patients with endometrial carcinoma: A new model based on demographics, biochemical factors, and tumor histology. Gynecologic Oncology. 2013;129:28–32. doi: 10.1016/j.ygyno.2013.01.008.
37. 37. Njølstad TS, Engerud H, Werner HMJ, Salvesen HB, Trovik J. Pre-operative anemia, leukocytosis and thrombocytosis identify aggressive endometrial carcinomas. Gynecologic oncology. 2013;131:410–5.
38. 38. 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. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2018;226:25–9. doi: 10.1016/j.ejogrb.2018.05.028.
39. 39. Zhou X, Wang H, Wang X. Pre-operative CA125 and fibrinogen in patients with endometrial cancer: a risk model for predicting lymphovascular space invasion. Journal of gynecologic oncology. 2017;28.