Use of Neutrophil-to-Lymphocyte Ratio Combined With CA-125 to Distinguish Endometriomas From Other Benign Ovarian Cysts.

Abstract

The objective of this study was to evaluate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) compared to CA-125 in patients with endometriomas. This study was designed as a retrospective comparative study. A total of 807 women who underwent surgery due to benign ovarian cysts between January 2008 and January 2013 were included in the study. The NLR and CA-125 levels were assessed separately and together, with a receiver-operating characteristic curve analysis for the diagnosis of endometriomas. The mean serum levels of NLR, CA-125, and combined markers were significantly higher in the study group (all P < .001). According to the highest Youden index, the cutoff values were found to be 23.7 IU/mL for CA-125 at 75% sensitivity and 81% specificity and 1.89 for NLR at 70% sensitivity and 74% specificity. The cutoff value for the combined marker was 41.0 with 80% sensitivity and 82% specificity. There was a positive correlation between NLR and CA-125 (P < .001). Neutrophil-to-lymphocyte ratio was also positively correlated with the endometriosis score (P < .001). Although NLR is a simple and easily applicable marker, CA-125 is superior for differentiating endometriomas from other benign ovarian cysts. The combination of these 2 markers improves diagnostic accuracy.