The Diagnostic Value Of Neutrophil-to-lymphocyte Ratio And It Combines With CA125 In Epithelial Ovarian Cancer

Objective:By comparing the preoperative peripheral blood neutrophil-to-lymphocyte ratio(NLR)and serum CA125 in epithelial ovarian cancer group with benign epithelial ovarian tumor group, discusses the two markers detection alone and in combination in ovarian epithelial carcinoma clinical value in diagnosis.Methods:Collect the exact cases of epithelial ovarian cancer or benign ovarian tumors in the gynecological ward of the Second Hospital of Shanxi Medical University from January2010 to December 2014.Select 46 cases of epithelial ovarian cancer as researched group,48 cases of benign ovarian tumors as control group.Sensitivity and specificity of serum CA125 and NLR for diagnosis of epithelial ovarian cancer were evaluated by receiver-operating characteristic(ROC) analysis. And analyze their correlations of staging and grading in epithelial ovarian cancer.By immunohistochemistry,CD163 marker M2 tumor associated macrophages, investigate preoperative NLR and tumor-associated macrophage infiltration.Results:1.Comparison of Clinical data in epithelial ovarian cancer group and benign ovarian tumors group:①The average age of patinents(54.36±8.92 vs.48.48±10.07),two groups the differences were not significant(P>0.05).②The leukocyte count(6.48±3.00 vs.5.60±1.14),two groups the differences were not significant(P>0.05).③Compared with benign ovarian tumors group,neutrophil count(5.09±3.59 vs.3.03±0.81),monocyte count(0.58±0.17 vs.0.35±0.10),NLR(5.23±6.48 vs.1.58±0.62) and CA125(237.24±249.56 vs.15.50±13.83)in the epithelial ovarian cancer group were higher and the differences were also significant(all P<0.05).④Compared with benign ovarian tumors group,lymphocyte count(1.27±0.45 vs.2.08±0.58),eosinophil count(0.07±0.06 vs.0.18±0.33),basophil count(0.03±0.04 vs.0.06±0.04)in the epithelial ovarian cancer group were lower and the differences were also significant(all P<0.05).2.Comparison of leukocyte count,NLR and serum CA125 in the different stages of epithelial ovarian cancer group:①Compared with the I+II group,neutrophil count(3.83±1.19 vs.5.58±4.08),serum CA125(25.57±11.76 vs.320.57±247.27) and NLR(3.26±1.11 vs.6.15±7.43),in the III+IV group was higher and the differences were also significant(all P<0.05).②Leukocyte count(5.37±1.58 vs.6.91±3.32),lymphocyte count(1.41±0.38 vs.1.22±0.47),monocyte count(0.54±0.19 vs.0.60±0.17),eosinophil count(0.09±0.07 vs.0.06±0.05) and basophil count(0.06±0.05 vs.0.02±0.02),two groups the difference were not significant(all P>0.05).3.Comparison of leukocyte count,NLR and serum CA125 in the different grades of epithelial ovarian cancer group:①Compared with the G1 group,Leukocyte count(4.98±0.83 vs.6.72±3.16),neutrophil count(3.38±0.30 vs.5.37±3.80),serum CA125(14.62±7.77 vs.273.14±251.12) and NLR(2.36±0.37 vs.5.70±6.88)in the G2+G3 group was higher and the differences were also significant(all P<0.05).②lymphocyte count(1.47±0.36 vs.1.24±0.46),monocyte count(0.56±0.23 vs.0.59±0.17),eosinophil count(0.08±0.04 vs.0.07±0.06),basophil count(0.09±0.06 vs.0.02±0.02),two groups the difference were not significant(all P>0.05).4.Comparison of the diagnostic usefulness of NLR and serum CA125 single or combined in epithelial ovarian cancer group: The area under curve of NLR and serum CA125 0.803 and 0.935,respectively.In the case of CA125, a fixed cutoff value of 35 IU/m was a sensitivity of 86.10% and a specificity of 95.80%.In all ovarian cancers, NLRyielded a sensitivity of 80.60% and a specificity of 75.00%at a cutoff value of 2.30.Two indicators combined detection sensitivity of 97.30% and specificity of71.25%. Two indicators of joint detection sensitivity is higher than single index, but specificity lower than single index, the sensitivity and speciality of CA125 were higher than NLR.5.Comparison of the diagnostic usefulness of NLR and serum CA125 in early stage epithelial ovarian cancer group:The aeras under curve of NLR and serum CA125 were0.754 and 0818,respectively.In the case of CA125, a fixed cutoff value of 35 IU/ml was a sensitivity of 60.00% and a specificity of 95.60%.In all ovarian cancers, NLR was a sensitivity of 66.70% and a specificity of 87.50%at a cutoff value of 2.64.Two indicators combined detection sensitivity of 86.68% and specificity of 83.65%. Two indicators of joint detection sensitivity is higher than single index, but specificity lower than single index, the sensitivity of CA125 was higher than NLR,the specificity of NLR was lower than CA125.6.Comparison of CD163 in epithelial ovarian cancer group and benign ovarian tumors group:Compared with benign ovarian tumors group,CD163-positive cells(55.69±22.10 vs.30.00±13.10)in the epithelial ovarian cancer group were higher and the differences were also significant(P<0.05).Conclusions:1.Our findings provide evidence for the association between NLR and epithelial ovarian cancer. Preoperative NLR, in combination with CA125, may represent a simple and cost-effective method of identifying ovarian cancers, and an elevated NLR may predict an adverse outcome in ovarian cancer.2.NLR is often accompanied by increased CD163, suggesting the role of M2 tumor associated macrophages in the pathogenesis of ovarian cancer can not be ignored.