title: Use of Neutrophil-to-Lymphocyte Ratio Combined With CA-125 to Distinguish Endometriomas From Other Benign Ovarian Cysts.
abstract: The objective of this study was to evaluate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) compared to CA-125 in patients with endometriomas.
  
  
  
  This study was designed as a retrospective comparative study. A total of 807 women who underwent surgery due to benign ovarian cysts between January 2008 and January 2013 were included in the study. The NLR and CA-125 levels were assessed separately and together, with a receiver-operating characteristic curve analysis for the diagnosis of endometriomas.
  
  
  
  The mean serum levels of NLR, CA-125, and combined markers were significantly higher in the study group (all P < .001). According to the highest Youden index, the cutoff values were found to be 23.7 IU/mL for CA-125 at 75% sensitivity and 81% specificity and 1.89 for NLR at 70% sensitivity and 74% specificity. The cutoff value for the combined marker was 41.0 with 80% sensitivity and 82% specificity. There was a positive correlation between NLR and CA-125 (P < .001). Neutrophil-to-lymphocyte ratio was also positively correlated with the endometriosis score (P < .001).
  
  
  
  Although NLR is a simple and easily applicable marker, CA-125 is superior for differentiating endometriomas from other benign ovarian cysts. The combination of these 2 markers improves diagnostic accuracy.
authors.affiliation: Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey aytekintokmak@gmail.com.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Tokmak
authors.affiliation: Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Gulçin
authors.initials: G
authors.lastname: Yildirim
authors.affiliation: Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Efser
authors.initials: E
authors.lastname: Öztaş
authors.affiliation: Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Serra
authors.initials: S
authors.lastname: Akar
authors.affiliation: Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Kudret
authors.initials: K
authors.lastname: Erkenekli
authors.affiliation: Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Gülşen
authors.affiliation: Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Nafiye
authors.initials: N
authors.lastname: Yilmaz
authors.affiliation: Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Uğur
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D018394:CA-125 Antigen / Q000097:blood*; D004715:Endometriosis / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000378:metabolism*; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism*; D010048:Ovarian Cysts / Q000097:blood / Q000175:diagnosis*; D012372:ROC Curve; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen
keywords: CA-125; benign ovarian cyst; combined marker; endometrioma; endometriosis; neutrophil-to-lymphocyte ratio