The value of the neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and ca-125 in differential diagnosis of ovarian endometriosis

Abstract

The definitive diagnosis of the endometriosis relies on direct visualization at the surgery and the histopathological verification of the endometrial glands and stroma in biopsies of suspected lesions. Non-invasive tests to diagnose the endometrioma are required to avoid the complications of the laparoscopy. The present study was carried out to compare the neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and CA-125 level in patients with endometrioma and in women with other benign ovarian cysts. Retrospective medical data of 73 women who underwent open or laparoscopic surgery for ovarian cysts and 40 healthy controls were analyzed. Patients with endometriomas, other benign ovarian cysts and controls were compared with respect to age, CBC parameters, and Ca-125 measurements to identify the factors associated with the presence of the endometrium. There were no significant differences among the three groups with respect to leukocyte count, neutrophil, lymphocyte, plateletcrit, reticulocyte distribution width, hemoglobin level, platelet count, and mean platelet volume. The neutrophil to lymphocyte ratio and platelet to lymphocyte ratio were also similar in all groups. However, Ca-125 level was significantly higher in patients with endometrioma [86 (36-130) U/ml] compared to that of the benign ovarian cyst group [21.5 (6-62) U/ml] and the healthy controls [26.5 (9-51) U/ml]. ROC curve analysis provided that a cut-off value of 44.5 U/ml could predict the presence of endometrioma with a sensitivity of 97 % and with a specificity of 96 %. Our findings clearly demonstrate that neither neutrophil to lymphocyte ratio nor platelet to lymphocyte ratio has any value in distinguishing women with endometrioma from those with other benign ovarian cysts or healthy controls. However, Ca-125 levels might be used to identify patients with endometrioma, with high sensitivity and specificity.