Preoperative Neutrophil-to-Lymphocyte Ratio Has a Better Predictive Capacity in Diagnosing Tubo-Ovarian Abscess

Abstract

Background: The aim of this study is to identify the inflammatory markers which predict a tubo-ovarian abscess (TOA) in the most accurate way. Methods: This study involves 312 women. Preoperative inflammatory markers in the study group were compared with those in the healthy control group to identify the most efficient predictor of TOA with a high sensitivity and specificity. The recommended cutoff values of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell count, and red cell distribution width were determined using receiver operating characteristic curve (ROC) analyses. Results: The area under the curve (AUC = 0.99) in the ROC analysis was found to be statistically significant for NLR (p < 0.001) with a cutoff value of ≥4.15 (95% CI 0.97-1.00, sensitivity 95.2%, specificity 99.4%). The positive predictive value of NLR was 99.2%, and the negative predictive value was 96.7% (p < 0.001). The recommended threshold for PLR was found to be 164.37 (AUC = 0.95, 95% CI 0.93-0.98, sensitivity 86.7%, specificity 92%), and the cutoff point of the white blood cell count in the ROC analysis was 9.55 × 10³/μl (AUC = 0.90, 95% CI 0.87-0.95, sensitivity 78.68%, specificity 96.68%). Conclusion: Preoperative NLR and PLR improve the predictive value of serum markers for the presence of TOA.

The effectiveness of neutrophil to lymphocyte ratio in prediction of medical treatment failure for tubo‐ovarian abscess

“…reported that WBC and neutrophil counts of the TOA patients are significantly higher than healthy controls. Also, they found that NLR and PLR values are higher in TOA patients who have normal WBC values than healthy controls . In our study, we also found that age, WBC and neutrophil counts, and TOA size were significantly different between the conservative treatment group and surgical intervention group.…”

“…In a previous study which had compared TOA patients and healthy controls, NLR was statistically significant with a cut‐off value of ≥4.15 (95% CI 0.97–1.00, sensitivity 95.2%, specificity 99.4%) in the definition of TOA. In the same study, median NLR was significantly lower in healthy patients compared to TOA patients at 1.9 and 9.3 rates, respectively . Some studies attempted to establish a threshold value of NLR to predict the severity and prognosis of the disease in septic patients.…”

Evaluation of the hematologic system as a marker of subclinical inflammation in hyperemesis gravidarum: a case control study

“…Different hematological parameters have been used to evaluate the inflammatory status of distinct disease states www. journals.viamedica.pl/ginekologia_polska in recent years [8,9]. Mean platelet volume (MPV), platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW) and platelet-to-lymphocyte ratio (PLR) are simple markers that have been shown to reflect inflammatory burden and disease activity in several disorders, including ulcerative colitis, spontaneous bacterial peritonitis, malignancies, and cardiovascular diseases [10,11].…”

The Existence of Continuous Systemic Inflammation in Pregnant Women with Hyperemesis Gravidarum

“…Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and red blood cell distribution width are novel serum inflammatory markers with higher sensitivity than other serum inflammatory markers such as CRP and WBC (13,(26)(27)(28). These markers also increase in different obstetric conditions such as spontaneous preterm delivery or gestational diabetes mellitus (17,24,29,30).…”

“…Recent studies have demonstrated that pregnant women with HG have higher inflammatory markers when compared to healthy pregnant women without HG in the first trimester. Measuring white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and red blood cell distribution width (RDW) is an inexpensive and convenient way to identify systemic inflammation in the body (12)(13)(14)(15). Studies have shown that NLR, PLR, and RDW values are highly associated with the prognosis of diseases related to inflammation (16)(17)(18)(19).…”