Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio Might Predict Pediatric Ovarian Torsion: A Single-Institution Experience and Review of the Literature

Nissen, Matthias; Sander, Volker; Rogge, Phillip; Alrefai, Mohamad; Tröbs, Ralf-Bodo

doi:10.1016/j.jpag.2020.12.003

Cited by 12 publications

(12 citation statements)

References 41 publications

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“…Some studies were included solely in the qualitative review of our study. All of them assessed the relationship between NLR and AT and reported that NLR could predict AT with impressive sensitivity/specificity, similar to our findings [ 21 – 23 ].…”

Section: Discussionsupporting

confidence: 88%

“…The cytokines released include IL-2, IL-6, IL-1 β , and TNF- α which are produced during ischemic and reperfusion injury [ 20 ]. The ischemic state also induces the release of endogenous cortisol, which consequently leads to lymphopenia [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…The addition of mean platelet volume could improve the accuracy of NLR results since there was an independent association between a low mean platelet volume and AT ( p < 0.05). Nissen et al [ 21 ] retrospectively investigated 88 pediatric patients (3 days up to 17.8 years) with ovarian pathology who were assigned to the AT or control group. Similarly, NLR, PLR, and WBC were all significantly elevated in patients aged older than 1 year.…”

Section: Discussionmentioning

confidence: 99%

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Predictive Role of Neutrophil to Lymphocyte Ratio in Adnexal Torsion: A Systematic Review and Meta-Analysis

Khanzadeh

Tahernia²,

Hernandez

et al. 2022

Mediators of Inflammation

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Introduction. The goal of this systematic review and meta-analysis was to consolidate the available data on the role of the neutrophil to lymphocyte ratio (NLR) in predicting adnexal torsion (AT), to help guide clinical decision-making and outcomes. Methods. We used Web of Science, PubMed, and Scopus to conduct a systematic search for relevant publications published before June 26, 2022. We reported standardized mean difference (SMD) with a 95% confidence interval (CI). Because a significant level of heterogeneity was found, we used the random-effects model to calculate pooled effects. We used the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) too for quality assessment. Results. Overall, 15 articles were included in the analysis. A random-effects model revealed that patients with AT had elevated levels of NLR compared to those with other adnexal masses ( SMD = 1.06 , 95 % CI = 0.67 to 1.45, p < 0.001 ). So, NLR had diagnostic value. In the subgroup analysis according to ethnicity, we found that Caucasian patients with AT had elevated levels of NLR compared to patients who were operated due to adnexal mass and reported as having a benign ovarian cyst, without torsion ( SMD = 1.12 , 95 % CI = 0.71 to 1.54, p < 0.001 ). However, in the case of East Asian patients, there was no difference between cases and controls ( SMD = 0.86 , 95 % CI = − 0.21 to 1.94, p = 0.11 ). The pooled sensitivity of NLR was 0.79 ( 95 % CI = 0.72 – 0.85 ), and the pooled specificity was 0.84 (95% CI, 0.74–0.91). Conclusion. In conclusion, there has been an interest in the use of NLR as a diagnostic marker for AT.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictive Role of Neutrophil to Lymphocyte Ratio in Adnexal Torsion: A Systematic Review and Meta-Analysis

Khanzadeh

Tahernia²,

Hernandez

et al. 2022

Mediators of Inflammation

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“…One retrospective study of 201 patients found the optimal cut-off value for NLR and PLR in the diagnosis of adnexal torsion were 2.51 (sensitivity 72%; specificity 78%) and 154.4 (sensitivity 61%; specificity 64%) respectively 22. Similar findings were reported in paediatric patients, with a raised PLR being found to be an independent predictor of ovarian torsion (binary logistic regression analysis PLR P=0.18) 23…”

Section: What Initial Investigations Are Needed?supporting

confidence: 62%

“…More recently, several studies have assessed the role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in diagnosing adnexal torsion, although no international guidelines recommend their use in clinical practice yet 2223. One retrospective study of 201 patients found the optimal cut-off value for NLR and PLR in the diagnosis of adnexal torsion were 2.51 (sensitivity 72%; specificity 78%) and 154.4 (sensitivity 61%; specificity 64%) respectively 22.…”

Section: What Initial Investigations Are Needed?mentioning

confidence: 99%

Recognition and initial management of ovarian torsion

Ashmore

Blackstock

Kenny

et al. 2023

BMJ

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Ovarian torsion in the pediatric population: predictive factors for ovarian-sparing surgery—an international retrospective multicenter study and a systematic review

Spinelli

Tröbs

Nissen

et al. 2022

Arch Gynecol Obstet

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Study objective Ovarian torsion (OT) in pediatric age is a challenging condition to diagnose and treat. To date, there is still no clear consensus about its management. Our aim was to assess some possible associated factors that can help surgeons in decision-making. Design We conducted a retrospective multicentric study of pediatric OT surgically treated between 2010 and 2020 in six Italian and German institutions, comparing our findings with a literature review of the last 10 years (2010–2020). Participants Patients aged 0–18 years with a diagnosis of OT intraoperatively confirmed and surgically treated at the involved institutions. Results Ninety-seven patients with a mean age at diagnosis of 8.37 years were enrolled in the study. Severe abdominal pain was present in 82 patients (84.5%). Eighty children (82.5%) presented an enlarged ovary with an US diameter > 5 cm and only 32 (40%) of them underwent conservative surgery. A laparoscopic approach was performed in 60 cases (61.9%) although in 15 (15.5%) conversion to open surgery was deemed necessary. A functional cyst was present in 49 patients (50.5%) while 11 children (11.3%) suffered from OT on a normal ovary. Conclusions Our results showed that a post-menarchal age (p = .001), a pre-operative US ovarian size < 5 cm, (p = .001), the presence of severe abdominal pain (p = .002), a laparoscopic approach (p < .001), and the presence of a functional cyst (p = .002) were significantly associated with conservative surgery.

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Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio Might Predict Pediatric Ovarian Torsion: A Single-Institution Experience and Review of the Literature

Cited by 12 publications

References 41 publications

Predictive Role of Neutrophil to Lymphocyte Ratio in Adnexal Torsion: A Systematic Review and Meta-Analysis

Predictive Role of Neutrophil to Lymphocyte Ratio in Adnexal Torsion: A Systematic Review and Meta-Analysis

Recognition and initial management of ovarian torsion

Ovarian torsion in the pediatric population: predictive factors for ovarian-sparing surgery—an international retrospective multicenter study and a systematic review

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