Abstract
ABSTRACTPurpose To determine the utility of preoperative complete blood count (CBC) based systemic inflammatory markers in the prediction of testicular cancer and its prognosis.Material and MethodsBetween 2008-2017 the data of all testicular tumor patients undergoing radical orchiectomy were retrospectively analyzed. Patient baseseline characteristics (age, tumor stage, tumor markers, etc.) and results of routine preoperative blood tests including mean platelet volume (MPV), red cell distribution width (RDW), lymphocyte ratio (LR) and neutrophil ratio (NR) were retrieved. In addition, neutrophil to lymphocyte ratio (NLR) was calculated.Results Mean age of the tumor and control group was 36.0±15 and 30.50±11 years, respectively. Mean RDW, NR and NLR were significantly higher in the tumor group with p values<0.001; whereas LR and MPV were significantly higher in the control group (p<0.001). Receiver Operating Characteristic (ROC) analyses of LR, NR, RDW, MPV, and NLR are shown in Table-3. The cut off values for RDW and NR were found as 13,7 (Area under the curve (AUC): 0.687, sensitivity = 42.2%, specificity = 84.8%) and 55.3 (AUC:0.693, sensitivity 72.2%, specificity 62%), respectively. Area under the curve for NLR in tumor group was 0.711, with a threshold value of 1.78 and sensitivity=81.8% and specificity=55.4% (AUC:0.711/sig<0.001) that together with RDW exhibited the best differential diagnosis potential which could be used as an adjuvant tool in the prediction of testicular tumor and its prognosis.Conclusion Several systemic inflammatory markers, which are obtained by routinely performed cost-effective blood tests, could demonstrate incremental predictive and prognostic information adjuvant to preoperativly achieved testiscular tumor markers.
Highlights
Testicular cancer is the most common malignancy in men between the ages of 20-40 and constitutes about 1-1.5% of all cancers
Based on the above mentioned hypothesis, we aimed to determine the utility of preoperative complete blood count (CBC) based systemic inflammatory markers in the prediction of testicular cancer and its prognosis
Pathological subtypes consisted of 90 germ cell tumors including 42 seminomas (46.6%), 48 non-seminoma (53.4%), with a mean follow-up period of 39.83 months
Summary
Testicular cancer is the most common malignancy in men between the ages of 20-40 and constitutes about 1-1.5% of all cancers. Taken into account the role of inflammation in tumor biology, using inflammatory markers such as neutrophil ratio (NR), lymphocyte ratio (LR) and/or neutrophil to lymphocyte ratio (NLR) in predicting the occurence and prognosis of the disease, is of great importance [6]. Among these markers, it has been suggested that, especially NLR reflects immune response and can be used as a prognostic marker, in many urologic malignancies [7]. As a result of previously accomplished studies, the European Urological Association approved NLR as a prognostic parameter for RCC [8]
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