title: Pre-operative systemic inflammatory response markers in predicting lymph node metastasis in endometrioid endometrial adenocarcinoma.
abstract: OBJECTIVE
  To evaluate the correlation of pre-operative systemic inflammatory response (SIR) markers with lymph node (LN) metastasis compared with serum CA-125 in endometrioid endometrial adenocarcinoma.
  
  
  METHODS
  Retrospective review of 319 patients who were pathologically proven to have endometrioid endometrial adenocarcinoma after staging operations. Serum CA-125 and pre-operative SIR markers [neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), C-reactive protein (CRP), albumin, platelets and fibrinogen] were assessed. Receiver operating characteristic (ROC) curves were plotted for each SIR marker and serum CA-125.
  
  
  RESULTS
  NLR, PLR and serum CA-125 were higher in the LN-positive group compared with the LN-negative group (p=0.003, 0.012 and 0.025, respectively). Serum albumin was significantly lower in the LN-positive group compared with the LN-negative group (p<0.001). ROC curves demonstrated the best cut-off values for NLR (≥1.97), PLR (≥9.14), albumin (≤4.15 g/dl) and serum CA-125 (≥32.50 U/ml) for pre-operative diagnosis of LN metastasis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of serum CA-125 were 63.3%, 87.6%, 37.3%, 95.4% and 85.1%, respectively. No pre-operative SIR markers were superior to serum CA-125 in terms of sensitivity, specificity, PPV, NPV or accuracy, with the exception of the slightly higher sensitivity of PLR (64.5%).
  
  
  CONCLUSIONS
  Pre-operative SIR markers do not appear to be more effective in predicting LN metastasis than serum CA-125 in endometrioid endometrial adenocarcinoma.
authors.affiliation: Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Suh
authors.forename: Hee Seung
authors.initials: HS
authors.lastname: Kim
authors.forename: Hyun Hoon
authors.initials: HH
authors.lastname: Chung
authors.forename: Jae Weon
authors.initials: JW
authors.lastname: Kim
authors.forename: Noh Hyun
authors.initials: NH
authors.lastname: Park
authors.forename: Yong Sang
authors.initials: YS
authors.lastname: Song
authors.forename: Soon-Beom
authors.initials: SB
authors.lastname: Kang
mesh_terms: D000328:Adult; D000418:Albumins / Q000378:metabolism*; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000378:metabolism*; D018394:CA-125 Antigen / Q000097:blood*; D018269:Carcinoma, Endometrioid / Q000097:blood* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D012189:Retrospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood
chemical_list: D000418:Albumins; D018394:CA-125 Antigen; D002097:C-Reactive Protein