Correlation Study Of Platelet Lymphocyte Ratio And Platelet Count With Lymph Node Metastasis In Endometrial Cancer

Objective:Currently,Endometrial Carcinoma(EC)Lymph Node Metastasis(LNM)lacks biomarkers with early predictive value.The purpose of this study is to explore the relationship between preoperative hematological parameters and lymph node metastasis in patients with endometrial cancer,in order to provide a reference for clinical planning of surgical plans.Method:All 226 patients with endometrial cancer who underwent a complete staging operation for endometrial cancer in our hospital from January 1,2015 to December31,2019 were included in this retrospective cohort study.The general clinical data,hematology parameters,preoperative serum CA125 and postoperative pathological data within 2 weeks before operation of all patients were collected.And we calculate the platelet lymphocyte ratio(PLR),neutrophil lymphocyte ratio(NLR),and monocyte lymphocyte ratio(MLR)and draw the ROC curve and pass the maximum approximation.The Youden index determines the best cut-off value,sensitivity and specificity of PLR and PLT in endometrial cancer lymph node metastasis.And the cut-off value divides patients into low PLR group and high PLR group,low PLT group and high PLT group.We separately analyze the relationship between preoperative PLR,PLT and clinical pathology.χ~2 test and Fisher exact probability test were used to perform univariate analysis on the related factors of endometrial cancer lymph node metastasis.Multivariate logistic regression analysis gradually were used to screen the independent predictors of endometrial cancer lymph node metastasis.And we calculated the area under curve(AUC),sensitivity,and specificity through ROC curve to evaluate the predictive power of these independent predictors and combined indicators.Result:1.According to the ROC curve,the optimal truncation values of PLR and PLT were determined to be 174.0 and 281.5(109/L)respectively.2.Platelet count in endometrial cancer patients was correlated with pathological stage,lymph vascular space invasion(LVSI),deep muscle invasion,and lymph node metastasis,and the differences were statistically significant(P<0.05).The size of PLR in endometrial cancer patients was correlated with pathological stage,cervical interstitial invasion and lymph node metastasis,and the differences were statistically significant(P<0.05).3.According to univariate analysis,low degree of tumor differentiation,late pathological stage,non-endometrioid carcinoma,LVSI,deep muscle layer invasion,maximum tumor diameter of≥2cm,cervical interstitial invasion,CA125>35U/ml,PLT>281.5(10~9/L)and PLR>174.0 were all high risk factors for lymph node metastasis of endometrial carcinoma(P<0.05).After multivariate Logistic regression analysis,LVSI,tumor maximum diameter≥2cm,CA125>35U /ml and PLR>174.0 were independent predictors of lymph node metastasis,and the differences were statistically significant(P<0.05).4.The accuracy of PLR>174.0,CA125>35U/ m L,tumor diameter≥2cm and LVSI in the diagnosis of lymphatic metastasis of endometrial cancer were67.6%,67.6%,68.6% and 81.2%,respectively.The accuracy,sensitivity and specificity of the combined diagnosis of PLR,CA125 and tumor size were 82.7%,74.2% and 74.9%,indicating that the predictive value of the combined diagnosis was higher than that of the independent detection of other predictors,and the predictive efficiency was better.Conclusion:PLR is an independent predictor of lymph node metastasis in endometrial carcinoma.The combination of PLR,CA125 and tumor size has higher predictive value,which is helpful to provide reference for clinical surgical planning.