| Objective Inflammation and tumor immune related indicators have important diagnostic and predictive value in endometrial cancer.The purpose of this study was to perform a retrospective statistical analysis of patients with endometrial cancer(EC)and normal endometrium.Serum carbohydrate antigen(CA)125,neutrophil/lymphocyte ratio(NLR),and platelet/lymphocyte ratio(PLR)were analyzed.Preliminary estimates of the relationship between the three indicators and endometrial cancer.To evaluate the predictive value of three indicators alone and in combination in the diagnosis of endometrial cancer and to find the best diagnostic threshold.Hope to provide clinical guidance for the diagnosis of endometrial cancer.Methods We collected patient medical records from January 2012 to January 2017.They all came to our department of obstetrics and gynecology because of abnormal vaginal bleeding or fluid symptoms.And all patients were examined for endometrial pathology.All patients have complete records.These records included complete blood counts,serum CA125,and clinicopathologic data obtained prior to curettage.All patients were diagnosed with pathology as the final diagnosis.There were 179 cases of endometrial cancer diagnosed in pathological examination and 112 cases of normal endometrium in the same period.We established the former as the EC group(endometrial cancer group,experimental group),and the latter as normal group(normal endometrium group,control group).We used statistical methods to compare the relevant indicators in the two groups.The receiver operating characteristic curve(ROC)and logistic regression equations were used to analyze the diagnostic value of serum CA125,NLR and PLR alone and in combination with EC.It is expected to obtain the best diagnostic predictive value and analyze the relationship between the three indicators and the surgical-pathological staging of EC patients.Results 1.Clinical characteristics:In this study,291 patients were referred for abnormal vaginal bleeding or fluid.The duration of their symptoms ranged from about 0.5 months to 33 months and the average time was 7.5 months.The average age of the EC group was(55.56±7.90)years and the average age of the normal group(54.35±7.33)years.2.There was no significant difference in the white blood cell count and platelet count between the EC group and the normal group(P>0.05).The preoperative neutrophil count and lymphocyte count in the EC group were significantly higher than those in the normal group(P<0.05).The difference was statistically significant.Preoperative serum CA125,NLR,and PLR were significantly higher in the EC group than in the normal group(P<0.05).The difference was statistically significant.3.Correlation analysis showed that serum CA125 was positively correlated with NLR and PLR,respectively(P<0.05),and PLR was positively correlated with NLR(P<0.001).The AUC of CA125,NLR,and PLR under the ROC curve of the predicted EC was 0.706,0.648,and 0.555,respectively.The combined AUC of the three indicators predicting EC was 0.792,which was significantly higher than the AUC predicted by the three indicators alone(P<0.05).The best cutoff value of serum CA125 is 21.35 U/ml,its sensitivity is 0.49,specificity is 0.88,and diagnostic accuracy is 64.3%.The best critical value of NLR is 2.03,its sensitivity is 0.66,specificity is 0.71,and diagnostic accuracy is 62.9%.The optimal cut-off value for PLR is 169.02,its sensitivity is 0.36,its specificity is 0.85,and its diagnostic accuracy is 54.6%.The optimal cut-off value of the combined detection was 0.62,with a sensitivity of 0.57,a specificity of 0.85,and an accuracy rate of 72.5%.4.Postoperative pathological analysis:(1)With FIGO stage progression,the levels of serum CA125,NLR,and PLR gradually increased(P<0.05),and the difference was statistically significant.(2)With the progression of grading,the level of serum CA125 gradually increased(P<0.05),and the difference was statistically significant.The levels of NLR and PLR did not increase with increasing grade(P>0.05),and the difference was not statistically significant.(3)The level of serum CA125 in endometrioid adenocarcinoma was higher than that in other types of patients(P<0.05).The level of serum CA125 in patients with metastasis was also higher than that in patients without metastasis(P<0.05).The depth of NLR in muscle infiltration was>11/2 The expression levels of endometrial cancer were significantly higher than those with muscle infiltration depth<1/2(P<0.05),and the difference was statistically significant.Conclusion 1.Abnormal vaginal bleeding and fluid are the main clinical manifestations of endometrial cancer.For patients with such symptoms after menopause and perimenopause.We need to be highly alert to endometrial lesions after excluding other related diseases.At the same time,the ideas for diagnosis and treatment should be broadened to improve the necessary inspections to reduce missed/misdiagnosed cases.2.Serum CA125,NLR,PLR may be potential markers for the diagnosis of endometrial cancer.Preoperative serum CA125,NLR,and PLR are related,and the combination of indicators can reduce the impact of other factors.The accuracy of joint detection and diagnosis is higher than that of individual detection.3.When the best predictive values for CA125,NLR,PLR,and combined detection were 21.35 U/ml,2.03,169.02,and 0.62,this may indicate a greater likelihood of endometrial cancer.The joint detection on the best predictive boundary also improves the overall accuracy.4.Preoperative levels of serum CA125,NLR,and PLR were positively correlated with the stage and progression of the disease.Serum CA125 andNLR can be used to evaluate endometrial cancer infiltration and lymphatic metastasis to some extent.5.The combined detection of serum CA125,NLR,and PLR is a set of simple,accessible,reliable,non-invasive biological indicators.To a certain extent,they can carry out preliminary identification and diagnosis of endometrial cancer and normal patients to provide basis for determining the diagnosis. |
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