DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20182315

Using platelet-to-lymphocyte ratio as a diagnostic marker in malignant ovarian tumors

Abdelfattah M. Agameya, Kareem Labib, Fady Moiety

Abstract


Background: Ovarian malignancy, is the fifth global fatal disease for women, and the most common cause of death in Gynecological cancer. Objective was to evaluate any diagnostic role of Platelet-to-lymphocyte ratio in epithelial ovarian tumors.

Methods: A prospective analysis, over 1 year; (October 2016 to October 2017). Setting: University hospital’s Gynaecological oncology centre. Subjects & Methodology: A total of 36 patients with epithelial ovarian tumors, not under any adjuvant therapy and negative for any other malignancy, or any blood diseases causing blood count changes. All subjects underwent preoperative assessment of CA125 and Platelet-to-lymphocyte ratio (PLR), followed by a staging laparotomy and the appropriate management according to the standard protocols. Postoperative histopathological confirmation of the disease type, stage and grade was done for all cases.

Results: (77.8%) of the patients had early stage disease while (22.2%) had advanced stage. Neither mean platelet, lymphocytic counts, nor PLR express any significant difference between early and late stage disease. CA 125 levels, however changed significantly in advanced stages. PLR showed a statistically significant difference between the three stages of the disease (P=0.007).   There was a positive correlation between PLR and CA125 (r=0.184 and P=0.283).

Conclusions: PLR rise significantly with tumor stages and correlates significantly with CA125. No significant change in PLR values with tumor type or grade. PLR might be a potential diagnostic / prognostic marker of ovarian epithelial cancer.


Keywords


Ovarian tumors, Platelet-to-lymphocyte, Ratio

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References


Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics. CA: a cancer. J Clinic. 2011 Jul 1;61(4):212-36.

Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA: a cancer. J Clinic. 2011 Mar 1;61(2):69-90.

Daly M, Obrams GI. Epidemiology and risk assessment for ovarian cancer. Semin Oncol. 1998;25:255-64.

Van Haaften Day C, Shen YU, Xu F, Yu Y, Berchuck A, Havrilesky LJ et al. OVX1, macrophage‐colony stimulating factor, and CA‐125‐II as tumor markers for epithelial ovarian carcinoma. Cancer. 2001 Dec 1;92(11):2837-44.

Sinha P, Rastogi M, Agarwal V, Sachan M. Protein, Methylated DNA and Micro RNA: Potential Candidates Towards Sustainable Ovarian Cancer Diagnostics. Recent Adv Ovarian Cancer. 2016

Ashrafgangooei T, Rezaeezadeh M. Risk of malignancy index in preoperative evaluation of pelvic masses. Asian Pac J Cancer Prev. 2011 Jan 1;12(07):1727-30.

Cho H, Hur HW, Kim SW. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2009;58:15-23.

Soonthorn Thum T, Suraseranee Wory V, Kengsakol K, Wijaithmum K, Kasemsen P, Prommatt S. Thrombocytosis in advanced epithelial ovarian cancer. J Med Assoc Thai. 2007;90:1495-500.

Dabrow MB, Francesco MR, Mc Breaty FX, Caradonna S. The effect of platelet derived growth factor and receptors on normal and neoplastic human ovarian surface epithelium. Gynecol Oncol. 1998;71:29-37.

Gudducci A, Cosio S, Genazzani AR. Serum and tissue biomarkers as predictive and prognostic variables in epithelial cancer. Crit Rev Oncol Hematol. 2009;69:12-27.

Badgwell D, Bast Jr RC. Early detection of ovarian cancer. Disease Markers. 2007;23(5,6):397-410.

Ma XM, Sun X, Yang GW, Yu MW, Zhang GL, Yu J et al. The platelet-to-lymphocyte ratio as a predictor of patient outcomes in ovarian cancer: a meta-analysis. Climacteric. 2017 Sep;20(5):448-55.

Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012;23(4):265-73.

Asher V, Lee J, Innamaa A, Bali A. Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer. Clin Translational Oncol. 2011 Jul 1;13(7):499.

Prodromidou A, Andreakos P, Kazakos C, Vlachos DE, Perrea D, Pergialiotis V. The diagnostic efficacy of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in ovarian cancer. Inflamm Res. 2017 Jun;66(6):467-75.

Chuan T, Wei S, Xia T, Yong S. Prognostic significance of platelet‐to‐lymphocyte ratio in patients with ovarian cancer: A meta‐analysis. Eur J Clin Invest. 2018:e12917.

Yildirim MA, Seckin KD, Togrul C, Baser E, Karsli MF, Gungor T et al. Roles of neutrophil/lymphocyte and platelet/lymphocyte ratios in the early diagnosis of malignant ovarian masses. Asian Pac J Cancer Prev. 2014 Jan 1;15(16):6881-5.

Kokcu A, Kurtoglu E, Celik H, Tosun M, Malatyalıoglu E, Ozdemir AZ. May the platelet to lymphocyte ratio be a prognostic factor for epithelial ovarian cancer. Asian Pac J Cancer Prev. 2014 Jan 1;15(22):9781-4.