Association between Preoperative Serum Markers and Lymph Node Metastasis in Endometrioid Adenocarcinoma of Endometrium

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Published: Mar 30, 2018
DOI: https://doi.org/10.14456/tjog.2018.1
Keywords:
endometrioid adenocarcinoma of endometrium lymph node metastasis serum markers hemoglobin neutrophil/lymphocyte ratio platelet/lymphocyte ratio multiplication of neutrophil and monocyte counts platelet counts

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Roseleeya Aleediman
Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok, Thailand
Kamaitorn Tientong
College of Medicine, Rangsit University, Bangkok, Thailand

Abstract

Objective:  Serum markers play many roles in various cancers. Our aim is to investigate whether preoperative serum markers can be used for predicting lymph node (LN) metastasis in endometrioid adenocarcinoma of endometrium


Material and Methods: Clinical characteristics of all patients with pure endometrioid adenocarcinoma of endometrium who underwent complete surgical staging at Rajavithi hospital, between 1 January 2010 and 31 December 2014 were retrospectively reviewed. Preoperative serum markers including hemoglobin (Hb), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), multiplication of neutrophil and monocyte counts(MNM), platelet counts, mean platelet volume (MPV) and serum albumin levels were investigated. Sensitivity, specificity, PPV, NPV of serum markers to predict lymph node metastasis were evaluated.


Results: 283 patients who meet the study inclusion criteria were included. There were 40/283 (14.3%) of LN metastasis. LN metastasis was significantly associated with lower Hb level (p <0.001) and higher NLR, PLR, MNM and platelet count (p= 0.018, p= 0.004, p=0.008 and p=0.03 respectively). The best cut off values to identify lymph node metastasis were 11.85 for Hb ( 72.5% sensitivity, 59.7% specificity), 2.29 for NLR( 60.0% sensitivity, 61.7% specificity) 10.37 for PLR (67.5% sensitivity , 56% specificity), 0.0068 for MNM (70% sensitivity ,56% specificity) and 297,500 for platelet count ( 62.5% sensitivity, 57% specificity).


Conclusion:  Preoperative lower Hb level, higher NLR, PLR, MNM and platelet count are statistically and significantly related with lymph node metastasis. They can be used in clinical practice to rule in patients with low risk for LN metastasis without extra costs.


Keywords: endometrioid adenocarcinoma of endometrium, lymph node metastasis, serum markers, hemoglobin, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, multiplication of neutrophil and monocyte counts, platelet counts            

Article Details

How to Cite
(1)
Aleediman, R.; Tientong, K. Association Between Preoperative Serum Markers and Lymph Node Metastasis in Endometrioid Adenocarcinoma of Endometrium. Thai J Obstet Gynaecol 2018, 26, 59-67.
Issue
VOL. 26, NO. 1: (January - March 2018)
Section
Original Article

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