Could hematologic parameters be useful biomarkers for the diagnosis of endometriosis?

Abstract

OBJECTIVES: The objective of this study was to evaluate the diagnostic value of the neutrophil-tolymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and mean platelet volume (MPV) in patients with endometriosis as compared with healthy controls. BACKGROUND: Currently, no non-invasive diagnostic test of endometriosis has been implemented in clinical practice. METHODS: A total of 121 women with endometriosis and 136 controls participated in this retrospective study. The extent of the disease in the patients with endometriosis was determined using the American Society of Reproductive Medicine revised classifi cation. Sensitivities and specifi cities of NLR, LMR and MPV were evaluated by receiver-operating characteristic (ROC) analysis. RESULTS: Patients with endometriosis had higher neutrophil counts, white blood cell (WBC) levels, NLR, MPV, and lower lymphocyte count and LMR than the control group. The cutoff values were found to be 1.6 for NLR at 87.6 % sensitivity and 44.8 % specifi city and 8 for MPV at 75.2 % sensitivity and 68.4 % specfi city. For LMR, the cutoff value was 5.6 with 66.1 % sensitivity, 50 % specifi city. Patients with stages III or IV had signifi cantly lower MPV (p = 0.039) and LMR levels (p = 0.016) than patients with stages I or II. CONCLUSION: NLR, LMR, and MPV may be used to distinguish patients with endometriosis from controls (Tab. 4, Fig. 4, Ref. 37).

Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature

“…We failed to detect similar results in our previous study thus supporting again the high variability of the observations. On the other hand, in line with our present findings, some groups had already reported that neutrophil count and NLR were significantly increased in the endometriosis group [9,23,30,31].…”

“…On the contrary, NLR was found to be significantly increased in the endometriosis group by Cho et al, who evaluated the usefulness of NLR in diagnosing endometriosis compared to benign ovarian tumors and healthy controls [23]. The same result was subsequently confirmed by three other studies [9,30,31]. Kim and coworkers, comparing stage I-II to stage III-IV endometriosis cases who underwent laparoscopic conservative surgery for OMAs, did not find any difference in NLR [27].…”

“…Results for the inflammatory markers, including neutrophils, lymphocytes, PLR, and NLR, from the systematic review are presented in Table 7. Three studies showed that neutrophil count was higher in patients with endometriosis than in women without the disease [9,23,31]. On the other hand, three studies showed no significant difference among groups, either when considering OMAs or in non-OMA patients [14,25,28].…”

“…Importantly, our present study confirmed a significantly higher neutrophil count in patients with endometriosis. Among eight studies investigating the lymphocyte count [9,14,[23][24][25]27,28,31], only three of them reported a significantly lower mean cell count in endometriosis compared to controls [9,23,31], and no correlation between the stage of endometriosis and the lymphocyte count was observed by Kim et al [27]. Two studies found no difference between cases and controls in terms of NLR [25,28].…”

Analysis of Reciprocally Dysregulated miRNAs in Eutopic Endometrium Is a Promising Approach for Low Invasive Diagnostics of Adenomyosis

“…Thus, the inflammatory components of EM gave rise to diagnostic methods based on the detection of anti- or pro-inflammatory cytokines in the peritoneal fluid and plasma [ 12 ]. EM-associated aberrations of the immune system’s functionality (decreased T cell reactivity and natural killer (NK) cells cytotoxicity, the polyclonal activation of B cells, the production of autoantibodies, and altered neutrophil-to-lymphocyte or lymphocyte-to-monocyte ratios) might be evaluated via liquid biopsy tests [ 13 , 14 ]. Recent investigations revealed the specific EM-associated characteristics of the eutopic endometrium.…”