Neutrophil-to-lymphocyte ratio as an adjunct to CA-125 for the diagnosis of endometriosis.
OBJECTIVE
To investigate the clinical value of differential white blood cell counts and neutrophil-to-lymphocyte ratio (NLR), by themselves or as adjunct to CA-125, in the diagnosis of endometriosis.


METHODS
Retrospective study.


METHODS
University Medical Center.


METHODS
Two hundred thirty-one patients with endometriosis, 145 patients with benign ovarian tumors, and 384 healthy controls participated in this study.


METHODS
None.


METHODS
Sensitivities and specificities of differential white blood cell (WBC) counts, NLR, serum CA-125, and the combined marker (NLR and serum CA-125) were evaluated by receiver-operating characteristic (ROC) analysis.


RESULTS
The mean NLR and the combined marker in patients with endometriosis were significantly higher than those in patients without endometriosis. The NLR was able to discriminate patients with endometriosis from those with benign ovarian tumors and from healthy controls, and 25 of the 38 endometriosis patients (65.8%) with minimal-to-mild disease exceeded the cutoff value. The combined marker had a sensitivity of 69.3% and specificity of 83.9% with a cutoff value of 55.7, showing 13.5% increase in sensitivity but 8.9% decrease in specificity when compared with serum CA-125 at a cutoff level of 35 IU/mL. The elevated combined marker detected 16 patients with endometriosis (42.1%) with minimal-to-mild disease, whereas only 10 patients (26.3%) had their serum CA-125 levels at more than 35 IU/mL.


CONCLUSIONS
Measurement of NLR and the combined marker may be used as simple and easily obtained diagnostic markers for endometriosis.
Department of Obstetrics and Gynecology, Yongdong Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea.
SiHyun
S
Cho
Hanbyoul
H
Cho
Anna
A
Nam
Hye Yeon
HY
Kim
Young Sik
YS
Choi
Ki Hyun
KH
Park
Dong Je
DJ
Cho
Byung Seok
BS
Lee
D000328:Adult; D018394:CA-125 Antigen / Q000097:blood*; D004715:Endometriosis / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D018655:Lymphocyte Count; D009504:Neutrophils; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D018394:CA-125 Antigen