Correlation Of Inflammation And Clotting Indicator With Pathological Features Of Endometrial Carcinoma

Objective: To explore the correlation between inflammation and coagulation indexes and pathological characteristics of endometrial cancer,evaluate their value in predicting the pathological characteristics of endometrial cancer,and search for the best cutoff value,so as to provide guidance for clinical diagnosis and treatment.Method: The clinical data of 208 patients with postoperative pathology revealed endometrial carcinoma who were admitted to The First Hospital of Lanzhou University and who underwent surgical pathological staging were retrospectively collected from January,2015 to October,2020.In addition,the clinical data of 208 patients with benign endometrial lesions reported by pathology after curettage and other operations due to irregular vaginal bleeding at the same period and age were collected as control group,endometrial cancer group was divided into groups according to different pathological features(including FIGO stage,pathological type,histological grade,muscular invasion,lymph node metastasis,and vascular invasion).Use of statistical methods for each group of inflammatory biomarkers lymphocyte count(L),neutrophil count(N)and mononuclear cell count(M),neutrophil count/lymphocyte count ratio(NLR),monocyte count/lymphocyte count ratio(MLR)provision,preoperative coagulation indexes: Fibrinogen(FIB),part of the activation of thrombin time(APTT),prothrombin time(PT),thrombin time(TT),statistical analysis of meaningful indicators in different pathological characteristics of Spearman correlation analysis,through draw ROC curve evaluation its predictive value of endometrial cancer severity,in order to obtain optimal estimation.Result: 1.Compared with control group,N,M,NLR,MLR,FIB,APTT in endometrial carcinoma group were statistically significant(P<0.05).L,PT,TT was not statistically significant(P>0.05);L,N,M,APTT,PT,TT had no statistical significance in FIGO stage,histological grade,vascular infiltration,lymph node metastasis,pathological type,and muscular infiltration(P>0.05).2.MLR was statistically different between FIGO staging group I+II and FIGO III+IV,Spearman correlation analysis showed that MLR was positively correlated with FIGO stage(r=0.183,P=0.008).The ROC curve results showed that the AUC was 0.674(95%CI: 0.570～0.778,P=0.009),the maximum Youden index was 0.356,the cut-off value was 0.21,the sensitivity was 76.2%,and the specificity was 59.4%.MLR was statistically different in the group with or without lymph node metastasis(P<0.05),Spearman correlation analysis showed that MLR was positively correlated with lymph node metastasis(r=0.170,P=0.014).The ROC curve results showed that the AUC was 0.689(95%CI: 0.559～0.820,P=0.015),the maximum Youden index was 0.423,and the cut-off value was 0.22,the sensitivity was 77.3%,and the specificity was 64.8%.There was no significant difference in MLR in pathological type,depth of muscular invasion and histological grade(P>0.05).3.NLR and FIB showed statistically significant differences in the group with or without lymph node metastasis(P<0.05),Spearman correlation analysis showed a positive correlation between NLR,FIB and lymph node metastasis(r=0.241,P<0.001;r =0.166,P=0.017);The ROC curve results showed that the AUC was 0.769(95%CI:0.659～0.879,P=0.001),the maximum Youden index was 0.398,and the cutoff value was 2.78,the sensitivity was 66.7%,and the specificity was 73.1%.The ROC curve results showed that the AUC was 0.685(95%CI: 0.536～0.834,P=0.017),the maximum Youden index was 0.353,the cut-off value was 2.95g/L,the sensitivity was46.67%,and the specificity was 88.60%.NLR and FIB had no significant statistical significance in FIGO stage,muscular infiltration,vascular infiltration,histological grade and pathological type(P>0.05).4.The AUC under the ROC curve of NLR,MLR and FIB combined assessment of lymph node metastasis was 0.783(95%CI: 0.664～0.902,P<0.001),the maximum Youden index was 0.521,specificity was 78.8%,sensitivity was 73.3%.Conclusion:1.There was a positive correlation between preoperative MLR and FIGO stage in endometrial cancer patients.The higher the MLR value,the later the patients’ stage.The optimal cut-off value for the FIGO stage assessment by MLR was0.21.2.There was a positive correlation between NLR,MLR,FIB and lymph node metastasis in endometrial cancer patients preoperatively.The higher the NLR,MLR,FIB values were,the greater the risk of lymph node metastasis.The optimal cut-off values for preoperative assessment of lymph node metastasis were 2.78,0.22 and2.95g/L,respectively.3.The combination of NLR,MLR and FIB was the most effective in the assessment of lymph node metastasis in patients with endometrial cancer.