The relationship between pre-operative lymphocyte to monocyte ratio and serum cancer antigen-125 among women with epithelial ovarian cancer in Lagos, Nigeria

Abstract

Ovarian cancer (OC) is the second most common genital cancer worldwide, and the most lethal of all genital cancers. The role of inflammation and markers of systemic inflammation such as neutrophils, lymphocytes and monocytes in cancer biology have been investigated and reported in many studies. Cancer antigen 125 (CA-125) is currently in use as an adjunct to diagnosis, prognostication and monitoring of epithelial OC (EOC). This test is not readily available in many centres in sub-Saharan Africa, creating a need to identify alternative markers that are available and affordable. This study aimed to determine the relationship between pre-operative serum lymphocyte to monocyte ratio (LMR) and CA-125 in EOC. This was a retrospective cross-sectional study among 70 women, diagnosed with EOC in Lagos University Teaching Hospital from January 2013 to December 2019. Data were extracted from the case notes of the patients. LMR was calculated as the absolute lymphocyte count divided by the absolute monocyte count and analysed using Statistical Package for Social Sciences (SPSS) version 25.0. The correlation between LMR and CA-125 was determined using Pearson's correlation coefficient. The mean age of the patients was 48.57 ± 13.97 years. Serous adenocarcinoma was the most common subtype of EOC making up 94.3% of the cases. The median serum CA-125 was 393.5 (215.00-765.67) U/mL. The median LMR was 6.77 (1.28-43.0). There was a statistically significant negative correlation between CA-125 and LMR, r = −0.28, p = 0.02. LMR was negatively associated with CA-125 in women with EOC. LMR may be considered as a simple, affordable alternative marker to CA-125 in the management of EOC.

Correlation between the neutrophil-to-lymphocyte ratio and clinicopathological parameters in epithelial ovarian cancer patients and its effect on prognosis—a retrospective cohort study

“…Our study showed that a high NLR may promote the proliferation and metastasis of ovarian cancer cells, manifested by an increased FIGO staging, lymph node metastasis, and ascites, which ultimately lead to a poor prognosis. These findings have been confirmed by several previous studies ( 21 , 22 ). In addition, studies have also shown that a high NLR is associated with the sensitivity of chemotherapy drugs in patients with ovarian cancer, which is manifested by patients with a high NLR reacting less after receiving chemotherapy ( 9 , 10 ).…”

Monocyte–Lymphocyte Ratio and Dysglycemia: A Retrospective, Cross-Sectional Study of the Saudi Population

“…In the latter, calculating MLR prior to surgical intervention could be of clinical value in predicting stage, grade, and metastasis. Additionally, MLR was associated with serum CA-125 levels in a retrospective, cross-sectional study of Nigerian ovarian cancer patients [ 63 ]. Furthermore, MLR performed better than NLR in predicting the progression and overall survival of bladder cancer patients [ 64 , 65 , 66 , 67 ], and was invaluable for the prognosis and survival of cervical cancer and non-small-cell lung cancer patients [ 68 , 69 ].…”