title: The utility of tumor markers and neutrophil lymphocyte ratio in patients with an intraoperative diagnosis of mucinous borderline ovarian tumor.
abstract: OBJECTIVE
  To evaluate the utility of tumor markers and complete blood count to increase the diagnostic accuracy to detect malignant cases that are intraoperatively reported as mucinous borderline ovarian tumors (BOT).
  
  
  METHODS
  Patients who underwent laparotomy at our gynecologic oncology clinic between 2007 and 2015 for evaluation of an adnexal mass with an intraoperative frozen section report of mucinous BOT were retrospectively analyzed. Patients were grouped according to the final pathological diagnoses (malignant, borderline and benign), and were compared in terms of tumor marker levels and complete blood count parameters. Significant parameters were evaluated together with frozen section results, and were assessed for diagnostic accuracy.
  
  
  RESULTS
  A total of 63 patients were included in the study. Of these, 41 patients had borderline, 11 patients had benign, and 11 patients had malignant mucinous ovarian tumors. Patient age, menopausal status, hemoglobin, platelet and lymphocyte counts were similar among the groups (p>0.05). On the other hand, white blood cell, neutrophil counts and neutrophil/lymphocyte ratio (NLR) were significantly higher in malignant cases (p<0.05). Similarly, CA125 and CA19-9 were significantly higher in malignant group (p<0.05). When evaluated with the frozen section results, CA19-9 and NLR had the highest sensitivity to detect mucinous cancers (81 and 78 percent, respectively).
  
  
  CONCLUSIONS
  In patients who have an intraoperative frozen section diagnosis of borderline mucinous ovarian tumors, CA19-9, NLR and CA125 were significant predictors of malignancy. In light of larger future studies, we believe that integrating these parameters into routine clinical practice may decrease the rate of under diagnosis.
authors.affiliation: Gynecology and Oncology Department, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey. Electronic address: doga_seckin@hotmail.com.
authors.forename: Kerem Doga
authors.initials: KD
authors.lastname: Seckin
authors.affiliation: Obstetrics and Gynecology Department, Sami Ulus Women and Children Health Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Karslı
authors.affiliation: Gynecology and Oncology Department, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Yucel
authors.affiliation: Gynecology and Oncology Department, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Bestel
authors.affiliation: Gynecology and Oncology Department, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Dogukan
authors.initials: D
authors.lastname: Yıldırım
authors.affiliation: Gynecology and Oncology Department, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Emel
authors.initials: E
authors.lastname: Canaz
authors.affiliation: Gynecology and Oncology Department, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Akbayır
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D000509:alpha-Fetoproteins
keywords: Diagnosis; Frozen section; Malignancy; Mucinous borderline tumor