Correlation Analysis Of Peripheral Blood Indexes And Clinicopathological Characteristics In Patients With Endometrial Cancer

Research background and purpose:Endometrial cancer is a gynecological malignant tumor with a high incidence.In recent years,the global incidence rate has been rising.In general,postoperative pathological results of endometrial cancer directly determine the prognosis.If we find one or more peripheral blood index which can effectively predict the clinicopathological characteristics of endometrial cancer before the surgery,we can improve the accuracy of clinicians' intraoperative decision-making and avoid overtreatment.The prognosis of endometrial cancer and the pathological results of staged surgery are predicted by diagnostic curettage.Exploring a peripheral blood index which can effectively predict clinicopathological characteristics before surgery will bring many benefits: improving the accuracy of clinicians' intraoperative decisions,avoiding overtreatment,preventing unnecessary auxiliary treatment,and providing patients with more accurate diagnosis and prognosis information.Recently,many scholars have paid more attention to the relationship between peripheral blood indicators that can predict systemic inflammation and malignant tumors.Many studies have shown that clinical and pathological characteristics of multiple malignant tumors are related with prognosis such as the peripheral blood neutrophil to lymphocyte count ratio(NLR),the mononuclear to lymphocyte count ratio(MLR),the platelet to lymphocyte count ratio(PLR).At present,there are few studies on these peripheral blood indicators and clinicopathological features of endometrial cancer,and the conclusions are controversial.This research analyzes the correlation between the clinicopathological characteristics of patients who are diagnosed with endometrial cancer after operation and the common peripheral blood indicators before surgery.Furthermore,the research explores their relationship with the pathological characteristics of endometrial cancer and the predictive value,which can provide a new idea for judging the occurrence,development,treatment and prognosis assessment of endometrial cancer.Method:We selecte patients with endometrial cancer who performed staged surgical treatment in the Obstetrics and Gynecology Department of the First Affiliated Hospital of Henan University from July 2017 to June 2019.We retrospectively analyze their clinical and pathological data.According to the inclusion and exclusion criteria,214 patients are included in the research who met the requirements.Their ages range from 27 to 76 years old,and the median age is 55 years old;there are pathological types including the endometrioid type which has 195 cases and the non-endometrioid type which has 19 cases.The surgery-pathological staging has 161 patients in stage I,17 patients in stage II,34 patients in stage III,and 2 patients in stage IV.The histological grade has 103 patients with high differentiation,75 patients with moderate differentiation,and 36 patients with low differentiation;There are 57 patients with myometrial infiltration depth?1/2;28 patients with cervical interstitial involvement;37 patients with vascular invasion;23 patients each extrauterine metastasis and lymph node metastasis each.We collect the preoperative data of pre-neutrophil count(N),lymphocyte count(L),monocyte count(M),platelet count(PLT),neutrophil-to-lymphocyte count ratio(NLR),monocyte-to-lymphocyte count Ratio(MLR),and platelet-to-lymphocyte count ratio(PLR),The patients are grouped according to different clinicopathological characteristics including pathological types,surgical-pathological stages,histological grades,depth of myometrial invasions,cervical interstitial involvements,vascular invasions,extrauterine and lymph node metastases.The patients' preoperative peripheral blood indexes N,M,L,PLT,NLR,MLR,PLR and their different clinicopathological characteristics are analyzed by SPSS24.0 and Graph Pad Prism 8.0 statistical software.Comparing the differences in peripheral blood of different clinicopathological features and their correlation with the clinicopathological features of endometrial cancer,Comparing the differences in the levels of peripheral blood indicators under different clinicopathological features,the Speraman correlation analysis of meaningful peripheral blood indicators and EC clinicopathological features are carried out.By drawing the ROC curve of peripheral blood indicators and EC clinicopathological features,the area under the curve and its 95% confidence interval determines the predictive performance of this indicator for clinical pathological features.We think P<0.05 indicating statistical has significance.Result:1.The N,L,M and PLT have no statistically significant difference in the different clinicopathological characteristics of endometrial cancer(P>0.05).2.The level of MLR is significantly higher than that of the corresponding group when the depth of muscular infiltration is?1/2,The difference is statistically significant(P =0.000);when the cervical interstitial is involved,The difference is statistically significant(P =0.004).There is no statistically significant difference in clinical pathological characteristics of stages,histological grades,vascular invasions,or extrauterine and lymph node metastasis(P>0.05).3.The depth of myometrial infiltration and cervical interstitial involvement are positively weakly correlated with MLR's Speraman correlation analysis(rs=0.2683,P <0.0001;rs=0.2515,P =0.0002).4.The ROC curve analysis results of MLR and myometrium infiltration ?1/2 depth reveals that AUC is 0.6687,P=0.0003.The optimal cutoff value,the sensitivity,and the specificity is respectively 0.235,45.1% and 17.8%.The MLR and ROC with cervical interstitial involvement Curve analysis results indicates that AUC is 0.6543,P = 0.0054.When the Youden index is 0.296,the cutoff value,and the sensitivity and the specificity is respectively 0.235,50%,and 20.4%.Conclusion:1.There is a positive correlation between MLR and the depth of uterine myometrium invasion and the cervical interstitial involvement.We can conclude that the higher of the MLR value,the more possible of deep uterine muscle invasions and cervical interstitial involvements.2.There is no significant correlation between NLR,PLR and clinicopathological features of the endometrial cancer.