Use of Neutrophil-to-Lymphocyte Ratio Combined With CA-125 to Distinguish Endometriomas From Other Benign Ovarian Cysts

Tokmak, Aytekin; Yıldırım, Gülçin; Öztaş, Efser; Akar, Serra; Erkenekli, Kudret; Gülşen, Pınar; Yılmaz, Nafiye; Uğur, Mustafa

doi:10.1177/1933719115620494

Cited by 32 publications

(54 citation statements)

References 34 publications

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“…Kim et al [21] reported that no significant correlation between CA125 and NLR in endometriosis patients, which is consistent with the result of the present study but contrary to the result reported by Cho et al [19] and Tokmak et al [7] Therefore, further studies are needed to evaluate these findings.…”

Section: Discussionsupporting

confidence: 85%

“…[16] Numerous studies demonstrated that both PLT and NEU were implicated in the pathogenesis of endometriosis and adenomyosis. [15,17,18] Cho et al [19] and Tokmak et al [7] reported that NLR was significantly positively correlated with the stage of endometriosis, and the combination of NLR and CA125 was more sensitive than CA125 alone for the differential diagnosis of endometriomas, which would be useful in identifying symptomatic patients with early-stage endometriosis. Therefore, we searched the probable relationship of these blood parameters with adenomyosis-derived PDA.…”

Section: Discussionmentioning

confidence: 99%

“…[6,7] Many studies have found that PLT and NEU can be applied to the diagnosis of clinical stages and prediction of diseases prognosis in tumors and endometriosis, and that their combination with CA125 could improve the diagnostic and predictive value. [8–10] However, the data published so far are limited and there has been little discussion about the correlation of CA125, PLT, and NLR with adenomyosis-derived PDA.…”

Section: Introductionmentioning

confidence: 99%

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CA125 modified by PLT and NLR improves the predictive accuracy of adenomyosis-derived pelvic dense adhesion

et al. 2017

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To explore the value of serum levels of CA125, platelet count (PLT), neutrophil–lymphocyte ratio (NLR), and modified CA125 markers CA125a and CA125b in predicting pelvic dense adhesion (PDA) associated with adenomyosis, CA125a = lg(CA125 × PLT × 109), CA125b = lg(CA125 × NLR).This retrospective study included 304 patients who underwent surgery for adenomyosis. Correlations of serum levels of CA125, PLT, NLR, and modified CA125 markers with adenomyosis-derived PDA were analyzed by Logistic regression. Receiver operating characteristic curve was applied to assess the utility of these parameters for predicting PDA.All the parameters including CA125, PLT, NLR, and modified CA125 markers were positively correlated with PDA (P < .05 or P < .01). More importantly, CA125a was more specific (85.03% vs. 83.00%) and more sensitive (47.56% vs. 47.47%) than CA125 alone for the prediction of PDA, and CA125b could also improve the predictive specificity of PDA (53.13% vs. 47.47%).Serum CA125, PLT, and NLR were all closely correlated with PDA in adenomyosis patients. CA125 modified by PLT and NLR could further improve the predictive accuracy of adenomyosis-derived PDA, thus providing more meaningful references for better-informed decisions about the mode of surgical access for the clinical treatment of adenomyosis.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CA125 modified by PLT and NLR improves the predictive accuracy of adenomyosis-derived pelvic dense adhesion

et al. 2017

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“…The neutrophil‐to‐lymphocyte ratio (NLR) has been proposed as a potential measure of disease severity. The NLR was positively correlated with the severity of endometriosis, and NLR combined with serum carbohydrate antigen (CA)125 level was indicative of disease progression and effective as a diagnostic tool for endometrioma . NLR was also found to be valuable for the diagnosis of endometriosis in patients with CA125‐negative serum .…”

Section: Introductionmentioning

confidence: 99%

Involvement of immune cells in the pathogenesis of endometriosis

Izumi

Koga

Takamura

et al. 2018

J of Obstet and Gynaecol

126

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Endometriosis is characterized by the implantation and growth of endometriotic tissues outside the uterus. It is widely accepted the theory that endometriosis is caused by the implantation of endometrial tissue from retrograde menstruation; however, retrograde menstruation occurs in almost all women and other factors are required for the establishment of endometriosis, such as cell survival, cell invasion, angiogenesis, and cell growth. Immune factors in the local environment may, therefore, contribute to the formation and progression of endometriosis. Current evidence supports the involvement of immune cells in the pathogenesis of endometriosis. Peritoneal neutrophils and macrophages secrete biochemical factors that help endometriotic cell growth and invasion, and angiogenesis. Peritoneal macrophages and NK cells in endometriosis have limited capability of eliminating endometrial cells in the peritoneal cavity. An imbalance of T cell subsets leads to aberrant cytokine secretions and inflammation that results in the growth of endometriosis lesions. It is still uncertain whether these immune cells have a role in the initial cause and/or stimulate actions that enhance disease; however, in either case, modulating the actions of these cells may prevent initiation or disease progression. Further studies are needed to deepen the understanding of the pathology of endometriosis and to develop novel management approaches of benefit to women suffering from this disease.

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“…The neutrophil-to-lymphocyte ratio (NLR) is a simple biomarker for inflammation; in a recent study, NLR was introduced as a marker in various diagnostic and prognostic gynecological procedures [15]. NLR has been also studied in some acute and chronic inflammatory diseases of the central nervous system.…”

Section: Www Journalsviamedicapl/ginekologia_polskamentioning

confidence: 99%

Diagnostic value of CA 19-9 in pregnancies complicated by spinal neural tube defects: a preliminary study

Tımur¹,

Tokmak

Yücel³

et al. 2016

Ginekol Pol

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Objectives: Various physiological and pathological conditions can induce significant variations in plasma concentrations of tumor markers, such as CA 19-9, which is present in the serum and amniotic fluid of pregnant women. Herein, we aimed to determine the clinical importance of maternal serum CA 19-9 levels in the diagnosis of neural tube defects (NTDs). Material and methods:A total of 100 women were included in this controlled cross-sectional study. Thirty-three patients whose pregnancies were complicated by isolated meningocele or meningomyelocele constituted the study group, whereas 33 normal, healthy pregnant women constituted the control group, and 34 age-and body mass index (BMI)-matched non-pregnant women were chosen for the validation group. Results:The mean maternal serum CA 19-9 levels were 17.2 ± 17.0 IU/mL, 7.1 ± 5.9 IU/mL, and 4.7 ± 3.6 IU/mL in the study, control, and validation groups, respectively (p < 0.001). ROC analyses showed that elevated CA 19-9 values may predict NTDs (p < 0.001). The cut-off value for CA 19-9 was found to be 9.6 IU/mL at 70% (51%-84%, 95% CI) sensitivity and 84% (74%-92%, 95% CI) specificity. Conclusions:CA 19-9 may be a promising noninvasive marker for NTDs. Further studies are needed to reveal the clinical applicability and diagnostic potential of maternal serum CA 19-9 levels in the identification of NTDs.

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Use of Neutrophil-to-Lymphocyte Ratio Combined With CA-125 to Distinguish Endometriomas From Other Benign Ovarian Cysts

Abstract: Although NLR is a simple and easily applicable marker, CA-125 is superior for differentiating endometriomas from other benign ovarian cysts. The combination of these 2 markers improves diagnostic accuracy.

Cited by 32 publications

References 34 publications

CA125 modified by PLT and NLR improves the predictive accuracy of adenomyosis-derived pelvic dense adhesion

CA125 modified by PLT and NLR improves the predictive accuracy of adenomyosis-derived pelvic dense adhesion

Involvement of immune cells in the pathogenesis of endometriosis

Diagnostic value of CA 19-9 in pregnancies complicated by spinal neural tube defects: a preliminary study

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