Diagnostic value of neutrophil to lymphocyte ratio in differentiation of ruptured ovarian cysts and adnexal torsion.

Sunullah Soysal,Rezzan Berna Baki

doi:10.4274/tjod.95881

Abstract

Objective:Ovarian cyst rupture and adnexal torsion (AT) differential diagnosis is important for early surgical intervention of AT for preserving ovarian function. The aim of this study was to evaluate the diagnostic value of preoperative the neutrophil-to-lymphocyte ratio (NLR) in patients with adnexal torsion and ovarian cyst rupture.Materials and Methods:Data of 80 patients who underwent surgery between 2012 and 2017 for ovarian cyst rupture, adnexal torsion, and unruptured ovarian cyst were analyzed. Patients were categorized as adnexal torsion (n=35), ovarian cyst rupture (n=20), unruptured ovarian cyst (n=25) groups. Preoperative NLR were compared among the three groups of the patients.Results:The adnexal torsion group had a median NLR of 8.0 (range, 4.0-14.1), the ovarian cyst rupture group had a median of NLR 7.5 (range, 3.7-11.5), and median NLR of the unruptured ovarian cyst group was 2.2 (range,1.8-2.7). The NLR was found to have a difference that reached statistical significance among the three groups (p<0.001). When the groups were individually compared, there was no significant difference between the ovarian cyst rupture and adnexal torsion groups (p=0.372), but there was a significant difference between the unruptured ovarian cyst and adnexal torsion groups (p<0.001).Conclusion:NLR may be useful in the differential diagnosis of unruptured ovarian cyst from adnexal torsion, but it has no diagnostic value for the differentiation of ovarian cyst rupture and adnexal torsion.

Highlights

Adnexal torsion (AT) can be defined as total or partial rotation of the adnexa around its own vascular axis
neutrophil-to-lymphocyte ratio (NLR) may be useful in the differential diagnosis of unruptured ovarian cyst from adnexal torsion, but it has no diagnostic value for the differentiation of ovarian cyst rupture and adnexal torsion
When the adnexal torsion (AT) group was compared with the other groups individually, the AT group had no significant difference with the ovarian cyst rupture (OCR) group but had a significant difference with the unruptured ovarian cysts (UOC) group (p=0.0834 and p

Summary

Introduction

Adnexal torsion (AT) can be defined as total or partial rotation of the adnexa around its own vascular axis. It results in venous and lymphatic blockage of ovarian tissue and causes congestion and hemorrhagic infarction leading to gangrene and hemorrhagic necrosis[1]. AT has the highest incidence among women aged between 20 and 30 years, it can be experienced by women at any age It is diagnosed in 2-7% women who undergo surgery for acute pelvic pain[3]. The diagnostic importance of MPV has been shown in diseases such as acute appendicitis, pelvic inflammatory, and ectopic pregnancy[7,8,9].

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Conclusion