Predictor Role of Systemic Inflammation in Ovarian Cancer

Abstract

Objective: The study aims to investigate the diagnostic value of hemogram derived systemic inflammation parameters in ovarian cancer.Methods: Totally, the study group consisted of 60 patients with suspected ovarian masses who underwent surgery between February 1th, 2020, and May 1th, 2021, in Ordu University Training and Research Hospital. The patients included in the study were divided into two groups according to postoperative histopathological diagnosis, benign group (consisting of 39 patients) and malign group (consisting of 21 patients). The analysis of the receiver operating characteristic (ROC) curve was used to discover the optimal cut-off values of the hemogram derived blood parameters to predict ovarian cancer.Results: In the cancer group; 85% of the patients were diagnosed with epithelial ovarian cancer and 62% at late stage. As compares with benign ovarian mass group, the ovarian cancer group had higher neutrophil counts (6.67+3.17 vs 4.64+1.94) (p=0.006), but lower lymphocyte counts (1.60+0.68 vs 2.22+0.64) (p=0.003). The high NLR values (cut-off 2.557) predict ovarian cancer with 71.4% sensitivity and 69.2% specificity (AUC 0.817, p=0.000, CI=0.712-0.922). The high dNLR values (cut- off 1.881) also predict cancer with similar sensitivity and specificity as NLR (AUC 0.814, p=0.000, CI 0.708-0.921). Significant cut-off values for the other hemogram derived parameters were 0.26, 0.0165, 159.66 and 770.611 for MLR, NPR, PLR and SII, respectively. Additionally, the high values of CA 125 (cut-off 34.45) and CA 15-3 (cut-off 16.4) was founded to be related with ovarian cancer.Conclusions: This paper revealed that high inflammatory parameters such as NLR and dNLR in patients with ovarian masses are mainly associated with ovarian cancer. In the study, it was emphasized that simple and easily accessible hemogram parameters should be used in addition to tumor biomarkers such as CA 125, CA 15-3, which are routinely used in predicting ovarian cancers. We think that more valuable results will be achieved with comprehensive studies designed prospectively.