The Diagnostic Accuracy of Hematologic Parameters, Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio, in Malignant and Benign Epithelial Neoplasms of the Ovary in Philippine General Hospital Service Patients

Abstract

Background and Objectives. Early detection of ovarian neoplasms confer a better outcome and prognosis for patients. Although newer diagnostic modalities have been recently developed, the availability and accessibility of complete blood count parameters specifically, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) make it a convenient and cost-effective marker to aid as a pre-operative predictor of epithelial ovarian neoplasms. We aim to determine the significance and relationship of preoperative NLR and PLR in predicting a diagnosis of malignant surface epithelial ovarian tumor. Methodology. We gathered surgical pathology reports and complete blood count parameters of service patients with benign and malignant surface epithelial ovarian neoplasms. Diagnostic accuracy of NLR andPLR was determined by using receiver operating curve (ROC) plots. Optimal cutoff points were set usingthe Youden index. Results. We have included 351 cases of ovarian surface epithelial neoplasms, 209 of which were benign and 142 of which were malignant. The ROC curve for PLR had an area under curve (AUC) of 0.6629 [0.6043, 0.7215]. The optimal cut-off point of was set at 195.99 with the maximal Youden index of 0.295 [9.193, 0.396]. The corresponding sensitivity of this test to determine malignancy at this point was 56.5% [47.8, 64.6] while the specificity was at 73.2% [66.7, 79.1]. The ROC curve for NLR had an AUC of 0.6616 [0.6051, 0.7180]. The optimal cut-off point of was set at 2.60 with the maximal Youden index of 0.316 [0.219, 0.413]. The corresponding sensitivity of this test to determine malignancy at this point was 76.1% [68.2, 82.8] while the specificity was at 55.5% [48.5, 62.4]. Conclusion. The utility of CBC parameters such as PLR and NLR are cost-effective tools which may have some diagnostic value but, they cannot be used as a stand-alone predictor of malignancy and must be correlated with other clinical, laboratory and radiologic studies.