Int J Med Sci 2021; 18(16):3712-3717. doi:10.7150/ijms.64658 This issue

Research Paper

Preoperative neutrophil-to-lymphocyte, platelet-to-lymphocyte and monocyte-to-lymphocyte ratio as a prognostic factor in non-endometrioid endometrial cancer

Heekyoung Song1*, Min Jin Jeong2*, Jimin Cha1, Ji Sun Lee1, Ji Geun Yoo3, Min Jong Song4, Jin Hwi Kim5, Sung Jong Lee1, Hae Nam Lee6, Joo Hee Yoon7, Dong Choon Park7, Sang Il Kim7✉

1. Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
2. Department of Obstetrics and Gynecology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
3. Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
4. Department of Obstetrics and Gynecology, Yeouido St. Mary's hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
5. Department of Obstetrics and Gynecology, Uijeongbu St. Mary's hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
6. Department of Obstetrics and Gynecology, Buchen St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
7. Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
*These authors contributed equally to this work.

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Citation:
Song H, Jeong MJ, Cha J, Lee JS, Yoo JG, Song MJ, Kim JH, Lee SJ, Lee HN, Yoon JH, Park DC, Kim SI. Preoperative neutrophil-to-lymphocyte, platelet-to-lymphocyte and monocyte-to-lymphocyte ratio as a prognostic factor in non-endometrioid endometrial cancer. Int J Med Sci 2021; 18(16):3712-3717. doi:10.7150/ijms.64658. Available from https://www.medsci.org/v18p3712.htm

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Abstract

Graphic abstract

Objective: Evaluate the prognostic value of neutrophil-lymphocyte ratio (NMR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) in patients with non-endometrioid endometrial cancer.

Method: Laboratory and clinicopathological data from 118 patients with non-endometrioid endometrial cancer who underwent surgical resection between January 2010 and December 2019 were reviewed. NLR, PLR and MLR were analyzed for correlations with recurrence and survival. The receiver operating characteristic (ROC) curves were generated for the NLR, PLR, and MLR. Optimal cut-off values were determined as the points at which the Youden index (sensitivity + specificity - 1) was maximal. Based on the results of the ROC curve analysis, the patients were grouped into high MLR and low MLR groups. Recurrence rate, disease-free survival, and overall survival were compared between the two groups. The prognostic factors were investigated using univariate and multivariate Cox proportional hazards model.

Results: The optimal cut-off value of MLR was 0.191 (AUC, 0.718; p < 0.001). Significantly more patients in the high MLR group experienced recurrence (60.3% vs. 15.6%, p < 0.0001) and cancer-related deaths (46.6% vs. 13.3%, p = 0.003). In multivariate analysis, advanced stage and high MLR were independent prognostic factors for disease-free survival and overall survival.

Conclusion: Elevated MLR was significantly associated poor clinical outcomes in patients with non endometrioid endometrial cancer. Our findings suggest that MLR may be clinically reliable and useful as an independent prognostic marker for patients with non-endometrioid endometrial cancer.

Keywords: endometrial cancer, uterine cancer, high risk, systemic inflammation response, prognostic factors, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, monocyte-lymphocyte ratio