Neutrophil to lymphocyte and platelet to lymphocyte ratios increase in ovarian tumors in the presence of frank stromal invasion.
OBJECTIVE
The aim of this study was to assess the predictive value of neutrophil/lymphocyte and platelet/lymphocyte ratios for borderline, malignant ovarian tumors, and borderline cases with microinvasion.


METHODS
Totally 275 women with sonographically detected ovarian tumor were enrolled for this study. All subjects underwent gynecological surgery via endoscopic or conventional approach and ovarian masses were all evaluated histopathologically by the same pathologist. All study population was divided into three groups as group with borderline tumors, benign tumors, or malignant tumors according to the histopathological diagnosis. Just before surgical intervention, a blood sample was obtained from each participant to analyze CA125 level, neutrophil, platelet, and lymphocyte count.


RESULTS
Neutrophil/lymphocyte ratio (AUC = 0.604, P = 0.02) was a significant predictor for malignant cases. Optimal cutoff value for the neutrophil/lymphocyte ratio was found to be 2.47 with 63.4% sensitivity and 63.5% specificity for malignancy prediction. Odds ratio of high neutrophil/lymphocyte ratio for malignancy risk was 2.5 (95% CI 1.3-4.8, P = 0.004). Platelet/lymphocyte ratio (AUC = 0.621, P = 0.007) was a significant predictor for malignant cases. Platelet/lymphocyte ratio (AUC = 0.568, P = 0.05) was also predictive for cases without a benign mass. Optimal cutoff value for the platelet/lymphocyte ratio was found to be 144.3 with 54% sensitivity and 59% specificity for malignancy prediction. Odds ratio of high platelet/lymphocyte ratio for malignancy risk was 2.1 (95% CI 1.1-3.8, P = 0.02).


CONCLUSIONS
Neutrophil/lymphocyte and platelet/lymphocyte ratios are predictors for malignant ovarian tumors but not borderline tumors even in case of microinvasion.
Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Health Training and Research Hospital, Opr. Dr. Burhanettin Üstünel Cad. No:10, Üsküdar/Istanbul, Turkey.
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Polat
Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Health Training and Research Hospital, Opr. Dr. Burhanettin Üstünel Cad. No:10, Üsküdar/Istanbul, Turkey.
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Senol
Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Health Training and Research Hospital, Opr. Dr. Burhanettin Üstünel Cad. No:10, Üsküdar/Istanbul, Turkey. enozkaya1979@gmail.com.
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Ozkaya
Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Health Training and Research Hospital, Opr. Dr. Burhanettin Üstünel Cad. No:10, Üsküdar/Istanbul, Turkey.
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Ogurlu Pakay
Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Health Training and Research Hospital, Opr. Dr. Burhanettin Üstünel Cad. No:10, Üsküdar/Istanbul, Turkey.
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Cikman
Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Health Training and Research Hospital, Opr. Dr. Burhanettin Üstünel Cad. No:10, Üsküdar/Istanbul, Turkey.
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Konukcu
Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Health Training and Research Hospital, Opr. Dr. Burhanettin Üstünel Cad. No:10, Üsküdar/Istanbul, Turkey.
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Ozten
Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Health Training and Research Hospital, Opr. Dr. Burhanettin Üstünel Cad. No:10, Üsküdar/Istanbul, Turkey.
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Karateke
D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D001792:Blood Platelets / Q000473:pathology*; D018394:CA-125 Antigen / Q000378:metabolism; D018284:Cystadenocarcinoma, Serous / Q000378:metabolism / Q000473:pathology; D016889:Endometrial Neoplasms / Q000378:metabolism / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D017154:Stromal Cells / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen
Borderline tumor; CA125; Neutrophil to lymphocyte ratio; Ovarian cancer; Platelet to lymphocyte ratio; Tumor diameter