Utility of Preoperative Tumour Markers and Neutrophil Lymphocyte Ratio in Ovarian Cancer Patients in Terms of Diagnostic Accuracy and Outcome: An Early and Inexpensive Tool to Stratify Prognosis

Authors : Das Sawmik, Kakoti Lopa mudra, Ahmed Shiraj, Sharma J D, Kalita Manuj, Sarma Anupam, Kataki A C

Volume/Issue : Volume 4 - 2019, Issue 11 - November

Google Scholar : https://goo.gl/DF9R4u

Scribd : https://bit.ly/34C0im2

 Introduction Increasing evidence suggest that cancer elicit inflammatory response and this inflammation plays an important role in carcinogenesis as well as their progression. Certain blood parameter changes reflect systemic inflammation and these changes have been linked to poor prognosis in patients with a few malignancies. Amongst the different blood parameters Neutrophil to lymphocyte ratio (NLR), has gained popularity in the literature as an easily derived and inexpensive marker of systemic inflammation. Several studies and meta-analyses consistently reported NLR as an unfavourable prognostic indicator for patients with gastrointestinal, lung, renal and gynaecological cancers. Many reports mentions the significance of NLR, thrombocytosis and serum Ca 125 levels as diagnostic workup also to subcategorize the different epithelial ovarian tumours.  Aims and Objectives The aim of our study was to evaluate the significance of different blood parameters with special emphasis on NLR ( pre treatment NLR) along with serum ca 125 ( pre treatment value)as diagnostic as well as prognostic patients with ovarian tumours.  Materials and Methods The data of 100 patients with ovarian tumours were collected and analysed from the department and hospital records retrospectively. Patients were grouped according to the final histopathological reports, considering it as gold standard, into benign, borderline and malignant ovarian epithelial tumours. The different data compared were age, serum Ca 125 levels and complete blood count parameters ( platelet count, lymphocyte count, neutrophil count, neutrophil lymphocyte ratio) among the 3 groups. Survival were analysed in malignant group at the end of 1, 2 and 3 years after receiving the treatment.  Results/ Observations Out of 100 patients, 83 patients were found to be matched with our inclusion criteria. Amongst them, 9 patients had borderline, 15 patients had benign, and 59 patients had malignant ovarian tumours. Mean age of the patients with malignant ovarian tumour were found be significantly higher than the benign mass. The mean value of Ca 125, Neutrophil Lymphocyte Ratio and Platelet Count (PC) were higher in malignant adnexal masses than in benign adnexal masses, but statistically significant was found in ca 125 and PC (p < 0.05). The overall survival rates of malignant tumours when compared with NLR show a significant association.  Conclusion Our preliminary analysis showed that NLR, PC and Ca-125 can be positively co-related to risk of malignancy in preoperative setting, although statistical significance was not found in our study. But, at the same time our data also showed that NLR and PC can be used to prognosticate malignant epithelial tumour to stratify at risk patients within the same disease stage for personalised follow up.


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