Comparison of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio levels in ovarian cyst among epithelial ovarian cancer patients at RSUP H. Adam Malik Medan, Indonesia
Downloads
HIGHLIGHTS
- Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) have potential as independent prognostic markers for ovarian cancer.
- This research was to evaluate NLR and PLR levels in ovarian cysts with epithelial ovarian cancer patients at RSUP H. Adam Malik Medan, Indonesia.
ABSTRACT
Objective: To assess Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as independent prognostic markers in epithelial ovarian cancer patients at RSUP H. Adam Malik Medan, Indonesia, considering the disease's common occurrence and typically late-stage diagnosis with a poor prognosis due to inflammatory processes implicated in malignancy mechanisms.
Materials and Methods: A comparative case-control study was conducted at the Department of Obstetrics and Gynecology, RSUP H. Adam Malik Medan, from December 2019 to February 2020. The study included 40 patients each diagnosed with ovarian cysts and epithelial ovarian cancer. Bivariate analysis was conducted using independent T-test for normally distributed data and the Mann-Whitney test for non-normally distributed data. Significance was established at p <0.05.
Results: The median NLR in the ovarian cancer group was 2.45 (1.06 to 38.44) and in the ovarian cysts group was 2.34 (1.44 to 3.78). Median PLR levels in ovarian cancer were 12813.94 (3178.08 to 19040.0) and in ovarian cysts were 11138.15 (5026.18 to 22839.51). Statistical analysis revealed no significant difference in NLR and PLR levels between ovarian cancer and ovarian cysts (p >0.05).
Conclusion: NLR and PLR levels demonstrated no significant difference between ovarian cancer and ovarian cyst patients at RSUP H. Adam Malik Medan, Indonesia. However, NLR and PLR can still serve as valuable markers for identifying malignant processes in patients suspected of malignancy.
Darus MG. Nilai NLR pada penderita tumor ovarium di RSUP H. Adam Malik Medan tahun 2017-2018 [NLR value among ovarian tumor patients at H. Adam Malik Hospital, Medan]. Medan: Universitas Sumatera Utara, Repository; 2019. Available from: http://repositori.usu.ac.id/ handle/123456789/16897.
Badora-Rybicka A, Nowara E, Starzyczny-SÅ‚ota D. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio before chemotherapy as potential prognostic factors in patients with newly diagnosed epithelial ovarian cancer. ESMO Open. 2016;1(2):e000039. doi: 10.1136/esmoopen-2016-000039. PMID: 27843595; PMCID: PMC5070273.
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):6881-5. doi: 10.7314/apjcp.2014.15.16.6881. PMID: 25169540.
Haruma T, Nakamura K, Nishida T, et al. Pre-treatment neutrophil to lymphocyte ratio is a predictor of prognosis in endometrial cancer. Anticancer Res. 2015;35(1):337-43. PMID: 2555 0569.
Zhang H, Lu J, Lu Y, et al. Prognostic significance and predictors of the system inflammation score in ovarian clear cell carcinoma. PLoS One. 2017;12(5):e0177520. doi: 10.1371/journal.pone. 0177520. PMID: 28498842; PMCID: PMC542 8928.
Kim HS, Choi HY, Lee M, et al. Systemic inflammatory response markers and CA-125 levels in ovarian clear cell carcinoma: A two center cohort study. Cancer Res Treat. 2016;48(1):250-8. doi: 10.4143/crt.2014.324. Epub 2015 Mar 6. PMID: 25761476; PMCID: PMC4720074.
Ceran MU, Tasdemir U, Colak E, et al. Can complete blood count inflammatory parameters in epithelial ovarian cancer contribute to prognosis? - a survival analysis. J Ovarian Res. 2019;12(1):16. doi: 10.1186/s13048-019-0491-7. PMID: 30744 662; PMCID: PMC6371536.
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. 2015;3(2):317-21. doi: 10.3892/mco.2014.481. Epub 2014 Dec 24. PMID: 25798260; PMCID: PMC4360876.
Chen S, Zhang L, Yan G, et al. Neutrophil-to-Lymphocyte Ratio is a potential prognostic biomarker in patients with ovarian cancer: A meta-analysis. Biomed Res Int. 2017;2017:7943467. doi: 10.1155/2017/7943467. Epub 2017 Jul 26. PMID: 28815182; PMCID: PMC5549495.
Chen L, Wang X, Shu J, et al. 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):212-8. doi: 10.1002/ijgo.12949. PMID: 31469423.
Li Z, Hong N, Robertson M, et al. Preoperative red cell distribution width and neutrophil-to-lymphocyte ratio predict survival in patients with epithelial ovarian cancer. Sci Rep. 2017;7:43001. doi: 10.1038/srep43001. PMID: 28223716; PM CID: PMC5320446.
Nurlailiyani. Hubungan antara usia pasien dengan derajat keganasan tumor ovarium primer di RSUD DR. Moewardi tahun 2011-2012 [Correlation between patient's age and malignancy level of primary ovarian tumor in Dr. Moewardi Hospital in 2011-2012]. Solo: Universitas Negeri Sebelas Maret. 2013.
SEER*Explorer: An interactive website for SEER cancer statistics [Internet]. Surveillance Research Program, National Cancer Institute; 2023 Apr 19. [updated: 2023 Jun 8; cited 2023 Aug 10]. Data source(s): SEER Incidence Data, November 2022 Submission (1975-2020), SEER 22 registries. Available from: https://seer.cancer.gov/statistics-network/explorer/.
Arora T, Mullangi S, Lekkala MR. Ovarian Cancer. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih. gov/books/NBK567760/
Shen F, Zhang X, Zhang Y, et al. Hormone receptors expression in ovarian cancer taking into account menopausal status: a retrospective study in Chinese population. Oncotarget. 2017;8(48):84019-27. doi: 10.18632/oncotarget.20251. PMID: 29137 401; PMCID: PMC5663573.
Gao Y, Zhao M, Dai X, et al. The prevalence of endometrial cancer in pre- and postmenopausal Chinese women. Menopause. 2016;23(8):884-7. doi: 10.1097/GME.0000000000000684. PMID: 27 272224.
Fuh KC, Shin JY, Kapp DS, et al. Survival differences of Asian and Caucasian epithelial ovarian cancer patients in the United States. Gynecol Oncol. 2015;136(3):491-7. doi: 10.1016/j. ygyno.2014.10.009. Epub 2014 Oct 16. PMID: 25455734.
Zhang H, Huo Q, Huang L, et al. Neutrophil-to-Lymphocyte Ratio in ovarian cancer patients with low CA125 concentration. Biomed Res Int. 2019;2019:8107906. doi: 10.1155/2019/8107906. PMID: 31341906; PMCID: PMC6614957.
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-lympho-cyte ratios. Mol Clin Oncol. 2015;3(2):317-21. doi: 10.3892/mco.2014.481. Epub 2014 Dec 24. PMID: 25798260; PMCID: PMC4360876.
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): 6881-5. doi: 10.7314/apjcp.2014.15.16.6881. PM ID: 25169540.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
1. Copyright of the article is transferred to the journal, by the knowledge of the author, whilst the moral right of the publication belongs to the author.
2. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution-Non Commercial-Share alike (CC BY-NC-SA), (https://creativecommons.org/licenses/by-nc-sa/4.0/)
3. The articles published in the journal are open access and can be used for non-commercial purposes. Other than the aims mentioned above, the editorial board is not responsible for copyright violation
The manuscript authentic and copyright statement submission can be downloaded ON THIS FORM.
