1. Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.
2. Department of Obstetrics and Gynecology, Pusan National University School of Medicine; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
3. Department of Obstetrics and Gynecology, Eulji Medical Center, Eulji University. Seoul, Korea
4. Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, Korea.
5. Department of Obstetrics and Gynecology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea.
6. Department of Obstetrics and Gynecology, Catholic University of Daegu, School of Medicine, Daegu, Korea.
7. Department of Obstetrics and Gynecology, Catholic University, Seoul, Republic of Korea.
ǂ Eo WK and Kim HY equally contributed to this article for first author.
* Both Kim KH and Park EJ equally contributed to this article for correspondence
Objective: To evaluate the role of inflammatory markers for distinguishing malignant and benign ovarian masses.
Methods: Preoperative demographic, clinicopathologic, and laboratory variables were reviewed in patients with an ovarian mass that was subsequently diagnosed as either epithelial ovarian cancer (EOC) or a benign ovarian mass on histologic analysis. The differences between variables of the two groups were further evaluated. Logistic regression analysis was applied to evaluate variables to predict the presence of EOC.
Results: According to the analysis of 229 patients with EOC, 120 (52.4%) patients had serous adenocarcinoma. Of the 229 patients, 110 (48.1%) patients had stage I or II disease and 119 (52.0%) had stage III or IV disease. There was a significant difference between EOC and benign ovarian mass in median values of variables such as age, white blood cell (WBC) count, hemoglobin concentration, platelet count, cancer antigen 125 (CA125) levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) (all P < 0.001, except for WBC count [P = 0.009]). In addition, there was significant difference in median values of these continuous variables among early-stage EOC, advanced-stage EOC, and benign ovarian mass (P < 0.001 for all variables). On multivariate logistic regression analysis, age (odds ratio [OR] = 4.14, P < 0.001), CA125 levels (OR = 9.87, P < 0.001), NLR (OR = 1.76, P = 0.049), PLR (OR = 2.41, P = 0.004), and LMR (OR = 0.51, P = 0.024) were found to significantly predict the presence of EOC.
Conclusion: The three LMR, NLR, and PLR markers were found to be predictors for the presence of EOC. Further prospective studies to assess these markers as screening tools for the presence of EOC are required.
Keywords: Inflammation, Biomarkers, Ovarian neoplasms, Early detection of cancer