title: Systemic leukocyte alterations are associated with invasive uterine cervical cancer.
abstract: OBJECTIVE
  The aim of the study was to evaluate blood leukocyte counts in patients with uterine cervical neoplasia.
  
  
  METHODS
  Patients treated at a university hospital were reviewed retrospectively. Disease progression was monitored, beginning in 1990 to 2002, for at least 5 years. Blood count parameters included absolute leukocyte, neutrophil and lymphocyte counts, leukocytosis (white blood cells > 10³/μL), neutrophilia (neutrophils ≥ 70% of leukocytes), lymphopenia (lymphocytes ≤ 15% of leukocytes), and the neutrophil-lymphocyte ratio (NLR), categorized as less than 5 or 5 or greater.
  
  
  RESULTS
  A total of 315 patients were enrolled: 182 (57.8%) with preinvasive neoplasia (cervical intraepithelial neoplasia [CIN] group), 95 (30.1%) with stages I to II (early group), and 38 patients (12.1%) with stages III to IV neoplasia (advanced group). Neutrophil and lymphocyte counts were elevated and reduced, respectively, at advanced stages compared with the CIN group (P < 0.05). Leukocytosis, neutrophilia, lymphopenia, and an NLR of 5 or greater were more frequent at advanced stages compared with the CIN and early-stage groups (P < 0.05). Moreover, neutrophilia was also significantly more frequent at early stage compared with the CIN group. The advanced group with neutrophilia had increased frequency of recidivism and metastasis than patients in the CIN group with neutrophilia (P < 0.05).
  
  
  CONCLUSIONS
  Patients with advanced cervical cancer had significantly higher frequency of leukocyte alterations, although they may occur apart from the preinvasive stages. Overall, neutrophilia was the best indicator of cancer invasiveness.
authors.affiliation: Department of Biological Sciences, Federal University of Triângulo Mineiro, Uberaba-MG, Brazil. bmurtafarmaco@dcb.uftm.edu.br
authors.forename: Beatriz M
authors.initials: BM
authors.lastname: Tavares-Murta
authors.forename: Maria A O
authors.initials: MA
authors.lastname: Mendonça
authors.forename: Natália L
authors.initials: NL
authors.lastname: Duarte
authors.forename: Juliana A
authors.initials: JA
authors.lastname: da Silva
authors.forename: Taciana S
authors.initials: TS
authors.lastname: Mutão
authors.forename: Cristiana B
authors.initials: CB
authors.lastname: Garcia
authors.forename: Eddie F C
authors.initials: EF
authors.lastname: Murta
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000209:etiology* / Q000473:pathology; D008231:Lymphopenia / Q000209:etiology / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000556:secondary*