The Prognostic Value Of Preoperative Neutrophil/Lymphocyte Ratio In Patients With Epithelial Ovarian Cancer

Objective : To investigate the relationship between preoperative neutrophil /lymphocyte ratio(NLR)and the clinical data of patients with epithelial ovarian cancer and clinical significance of preoperative NLR in evaluating the prognosis.Methods:We conducted a retrospective case study which covered 115 exact cases of patients with ovarian epithelial cancer admitted to the gynecological ward of the first affiliated hospital of Dalian medical university from January 2002 to January2012.According to different clinical factors groups,compared the difference of NLR.The patients were devided into two groups according to NLR=2.5 as the boundary value.Compared clinical data,progression free survival(PFS)and overall survival(OS)in two groups of patients.Analyzed factors affecting the prognosis through the single factor and multi factor analysis method.Results:According to the receiver operating characteristic curve(ROC)(Figure 1),with NLR=2.5 as the boundary value,the patients were devided into two groups,55 cases belonged to high NLR group(47.8%)and 60 cases(52.2%)belonged to low NLR group.High NLR group and low NLR group in histological classification(P = 0.006),FIGO stage(P = 0),ascites(P = 0.009),lymph gland metastasis(P = 0.01)and a decrease in the degree of tumor cytoreductive surgery(P = 0.001)were statisticallysignificant.And in age,types of pathology,ascites cytology and pelvic metastasis group had no statistic significance.When becoming devided degree was lower,when FIGO(International Federation of gynecology and obstetrics)stage was higher,when patients appeared malignant ascites before the surgery,when residual tumor was greater than1 cm,when lymph gland was transfered,when pelvic cavity was transfered,when the test of ascites cytology was positive,the meso-preoperative NLR(neutrophil /lymphocyte ratio)value was higher.Types of pathology,histological grade,FIGO stage,ascites cytology positive,lymph gland metastasis,pelviccavity transfered,degree of tumor Cytoreductive surgery not satisfied with,high NLR value were risk factors of effect overall survival time of ovarian epithelial cancer patients.Types of pathology,histological grade,FIGO stage,appearing ascites before surgery,ascites cytology positive,lymph gland metastasis,pelviccavity transfered,degree of tumor Cytoreductive surgery not satisfied with,high NLR value were risk factors for progresson free survivalof ovarian epithelial cancer patients.The meso-PFS(progression free survival)in preoperative high NLR(neutrophil / lymphocyte ratio)group of ovarian epithelial cancer patients was 21 months,the meso-PFS(progression free survival)in preoperative low NLR(neutrophil / lymphocyte ratio)group of ovarian epithelial cancer patients was 69 months.The meso-OS(total survival)in preoperative high NLR(neutrophil / lymphocyte ratio)group of ovarian epithelial cancer patients was 28 months,the meso-OS(total survival)in preoperative low NLR(neutrophil / lymphocyte ratio)group of ovarian epithelial cancer patients was 78 months.COX regression model analysis showed that preoperative NLR > 2.5 and FIGO stage were independent risk factors for overall survival and progression free survival in patients with epithelial ovarian cancer.Conclusion:Preoperative NLR is the independent prognositic factor of patients with epithelial ovarian cancer.