Relationship between inflammation markers and prognostic factors in grade I-II small-size (<4 cm) endometrioid type endometrial carcinoma
Abstract
Objectives:
To investigate the association between neutrophil / lymphocyte ratio (NLO) and
platelet / lymphocyte ratio (PLO) values and prognostic factors (myometrial
invasion, cervical invasion, lymph node involvement, and stage) in the complet
blood count of patients with <40 mm grade I-II endometrioid type endometrial
carcinoma (EEC).
Materials and Methods: In
this study, we retrospectively reviewed the records of patients who received
EEC diagnosis and underwent hysterectomy and retroperitoneal lymphadenectomy in
the gynecological clinic of Tepecik Training and Research Hospital between
January 2013 and January 2016. Grade I-II patients with tumors size less than
40 mm were studied and included in the study. Receiver operating characteristic
(ROC) curve analysis was used to determine the optimal cut-off value of
predictive prognostic factors in the EEC.
Results:
Patients with deep myometrial invasion, presence of cervical invasion, presence
of lymph node metastasis and advanced stage tumors were found to be higher of
NLO, PLO and CA125 values, and all results were found to be statistically
significant. According to ROC curve analysis, NLO was found to be the factor
with the highest area under curve for advanced stage, lymph node metastasis and
deep myometrial invasion. However, the highest area under curve for cervical
invasion was shown to have PLO value.
Conclusion: In
the grade I-II <4 cm tumors EEC patients who include advanced stage, lymph
node metastasis, deep myometrial invasion and cervical stromal invasion were
higher mean NLO, PLO and CA125 values. Systemic inflammation markers were found
to be associated with poor prognosis in EEC patients with grade I-II tumor size
<4 cm.
References
- 1. Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet. 2005;366:491–505.
- 2. Özgü E, Öz M, Yıldız Y, Özgü BS, Erkaya S and Güngör T. Prognostic value of 18F-FDG PET/CT for identifying high- and low-risk endometrial cancer patients. Ginekologia Polska 2016, vol. 87, no:7.
- 3. Nakamura K, Kodama J, Okumura Y, Hongo A, Kanazawa S and Hiramatsu Y. The SUVmax of 18F-FDG PET Correlates With Histological Grade in Endometrial Cancer. Int J Gynecol Cancer 2010;20: 110&115.
- 4. Haruma T, Nakamura K, Nishida T, Ogawa C, Kusumoto T, Seki N and Hiramatsu Y. Pre-treatment Neutrophil to Lymphocyte Ratio Is a Predictor of Prognosis in Endometrial Cancer. Anticancer Research 35: 337-344 (2015).
- 5. Bacanakgil B, Kaban I, Unal F, Guven R, Sahin E, Yildirim S. Predictive Value of Hematological Inflammatory Markers in Endometrial Neoplasia. Asian Pac J Cancer Prev,2018, 19 (6), 1529-1532.
- 6. Haldorsen IS and Salvesen HB. What Is the Best Preoperative Imaging for Endometrial Cancer? Curr Oncol Rep (2016) 18: 25.
- 7. Ural ÜM, Şehitoğlu İ, Tekin YB, Şahin FK. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in patients with endometrialhyperplasia and endometrial cancer. J Obstet Gynaecol Res. 2015 Mar;41(3):445-8.
- 8. Cakmak B, Gulucu S, Aliyev N, Ozsoy Z, Nacar M, Koseoglu D. Neutrophil-lymphocyte and platelet-lymphocyte ratios in endometrial hyperplasia. Obstet Gynecol Sci 2015;58(2):157-161.
- 9. Temur I, Kucukgoz U, Paydas S, Guzel AB, Sucu M, Vardar MA. Prognostic value of pre-operative neutrophil/lymphocyte ratio, monocyte count, mean platelet volume, and platelet/lymphocyte ratio in endometrial cancer. Eur J Obstet Gynecol Reprod Biol. 2018 Jul;226:25-29.
- 10. Ding L, Ding Y, Mao XH, Zhao JF, Zhou HJ. Retrospective study of the prognostic significance of neutrophil-to-lymphocyte ratio for postsurgical outcomes of patients with endometrial carcinoma. Int J Gynaecol Obstet. 2017 Sep;138(3):311-319.
- 11. Suh DH, Kim HS, Chung HH, Kim JW, Park NH, Song YS, Kang SB. Pre-operative systemic inflammatory response markers in predicting lymph node metastasis in endometrioid endometrial adenocarcinoma. Eur J Obstet Gynecol Reprod Biol. 2012 Jun;162(2):206-10.
- 12. Kadan Y, Calvino AS, Katz A, Katz S, Moore RG. Predictors for lymph nodes involvement in low risk endometrial cancer. J Obstet Gynaecol. 2017 May;37(4):514-518.
- 13. Acikgoz AS, Cakmak B, Tuten A, Oncul M, Eskalen S, Demirkiran F, Arvas M, Guralp O. Can preoperative neutrophil to lymphocyte and platelet to lymphocyte ratios predict cervical stromal involvement in endometrioid endometrial adenocarcinoma? Eur J Gynaecol Oncol. 2017;38(1):20-24.
Grade I-II Küçük Tümörlü (<4 cm) Endometrioid Tip Endometriyum Kanserinde İnflamasyon Belirteçlerinin Prognostik Faktörler ile İlişkisi
Abstract
Amaç:
40 mm’den küçük grade I-II endometrioid tip endometriyum kanseri (EEC)
hastalarında ameliyat öncesi periferal kan örneğinden bakılan tam kan sayımında
elde edilen nötrofil/ lenfosit oranı (NLO) ve platelet/ lenfosit oranı (PLO) değerleri
ile prognostik faktörler (myometriyal invazyon derinliği, servikal invazyon,
lenf nodu tutulumu, ve evre) arasındaki ilişkiyi araştırmakdır.
Materyal
metod: Bu çalışmada, Ocak 2013-Ocak 2016 tarihleri arasında
Tepecik Eğitim ve Araştırma Hastanesi Jinekolojik Onkoloji kliniğinde, EEC
tanısını alan ve histerektomi ve retroperitoneal lenfadenektomi işlemi yapılan
hastaların kayıtlarını retrospektif olarak gözden geçirdik. Sadece 40 mm’den
küçük tümörü olan ve grade I-II hastalar incelendi ve çalışmaya dahil edildi. EEC'de
prediktif prognostik faktörlerin optimal eşik (cut-off) değerini belirlemek için
ROC (Receiver operating characteristic) eğrisi analizi kullanıldı.
Bulgular:
Hastaların prognostik faktörlerinden derin myometriyal invazyon, servikal
invazyon varlığı, lenf nodu metastazı varlığı ve ileri evre tümörü olanlarda
NLO, PLO ve CA125 değerlerinin daha yüksek olduğu ve tüm sonuçların istatiksel
olarak anlamlı olduğu tespit edildi. Yapılan ROC analizinde ileri evre, lenf
nodu metastazı ve derin myometriyal invazyon için en yüksek eğri altında kalan
alana sahip faktörün NLO olduğu bulundu. Ancak servikal invazyon için en yüksek
eğri altında kalan alana PLO değerinin sahip olduğu gösterildi.
Sonuç:
Prognostik faktörlerden ileri evre, lenf nodu metastazı, derin myometriyal
invazyon ve servikal stromal invazyon varlığında grade I-II <4 cm tümörü
olan EEC hastalarında bakılan ortalama NLO, PLO ve CA125 değerlerinin daha
yüksek olduğu gösterildi. Sistemik inflamasyon belirteçlerinin grade I-II tümör
boyutu <4 cm olan EEC hastalarında kötü prognoz ile ilişkili olduğu
saptandı.
References
- 1. Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet. 2005;366:491–505.
- 2. Özgü E, Öz M, Yıldız Y, Özgü BS, Erkaya S and Güngör T. Prognostic value of 18F-FDG PET/CT for identifying high- and low-risk endometrial cancer patients. Ginekologia Polska 2016, vol. 87, no:7.
- 3. Nakamura K, Kodama J, Okumura Y, Hongo A, Kanazawa S and Hiramatsu Y. The SUVmax of 18F-FDG PET Correlates With Histological Grade in Endometrial Cancer. Int J Gynecol Cancer 2010;20: 110&115.
- 4. Haruma T, Nakamura K, Nishida T, Ogawa C, Kusumoto T, Seki N and Hiramatsu Y. Pre-treatment Neutrophil to Lymphocyte Ratio Is a Predictor of Prognosis in Endometrial Cancer. Anticancer Research 35: 337-344 (2015).
- 5. Bacanakgil B, Kaban I, Unal F, Guven R, Sahin E, Yildirim S. Predictive Value of Hematological Inflammatory Markers in Endometrial Neoplasia. Asian Pac J Cancer Prev,2018, 19 (6), 1529-1532.
- 6. Haldorsen IS and Salvesen HB. What Is the Best Preoperative Imaging for Endometrial Cancer? Curr Oncol Rep (2016) 18: 25.
- 7. Ural ÜM, Şehitoğlu İ, Tekin YB, Şahin FK. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in patients with endometrialhyperplasia and endometrial cancer. J Obstet Gynaecol Res. 2015 Mar;41(3):445-8.
- 8. Cakmak B, Gulucu S, Aliyev N, Ozsoy Z, Nacar M, Koseoglu D. Neutrophil-lymphocyte and platelet-lymphocyte ratios in endometrial hyperplasia. Obstet Gynecol Sci 2015;58(2):157-161.
- 9. Temur I, Kucukgoz U, Paydas S, Guzel AB, Sucu M, Vardar MA. Prognostic value of pre-operative neutrophil/lymphocyte ratio, monocyte count, mean platelet volume, and platelet/lymphocyte ratio in endometrial cancer. Eur J Obstet Gynecol Reprod Biol. 2018 Jul;226:25-29.
- 10. Ding L, Ding Y, Mao XH, Zhao JF, Zhou HJ. Retrospective study of the prognostic significance of neutrophil-to-lymphocyte ratio for postsurgical outcomes of patients with endometrial carcinoma. Int J Gynaecol Obstet. 2017 Sep;138(3):311-319.
- 11. Suh DH, Kim HS, Chung HH, Kim JW, Park NH, Song YS, Kang SB. Pre-operative systemic inflammatory response markers in predicting lymph node metastasis in endometrioid endometrial adenocarcinoma. Eur J Obstet Gynecol Reprod Biol. 2012 Jun;162(2):206-10.
- 12. Kadan Y, Calvino AS, Katz A, Katz S, Moore RG. Predictors for lymph nodes involvement in low risk endometrial cancer. J Obstet Gynaecol. 2017 May;37(4):514-518.
- 13. Acikgoz AS, Cakmak B, Tuten A, Oncul M, Eskalen S, Demirkiran F, Arvas M, Guralp O. Can preoperative neutrophil to lymphocyte and platelet to lymphocyte ratios predict cervical stromal involvement in endometrioid endometrial adenocarcinoma? Eur J Gynaecol Oncol. 2017;38(1):20-24.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | March 14, 2019 |
| Published in Issue | Year 2019 Volume: 50 Issue: 1 |
