Neutrophil to lymphocyte ratio for preoperative diagnosis of uterine sarcomas: A case-matched comparison
Neutrophil to lymphocyte ratio for preoperative diagnosis of uterine sarcomas: A case-matched comparison
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DOI：
10.1016/j.ejso.2010.05.004
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发表时间：
2010-07-01
期刊：
影响因子：
3.8
通讯作者：
Kang, S. B.
中科院分区：
文献类型：
--
作者：
Kim, H. S.;Han, K. H.;Kang, S. B.
背景：子宫肉瘤在所有的子宫恶性肿瘤中是罕见的，由于缺乏可行的术前诊断工具，常被误诊为子宫良性疾病，如平滑肌瘤、子宫腺肌症等。尽管一些研究表明血清CA-125水平在术前诊断中的作用，但其有效性仍存在争议。由于恶性肿瘤已知与导致血液学改变的全身炎症相关，我们通过病例匹配比较，比较了中性粒细胞与淋巴细胞比值（NLR）和血清CA-125水平对子宫肉瘤术前诊断的有效性。方法：2004年11月~ 2008年12月，将55例癌肉瘤（21例）、平滑肌肉瘤（20例）、子宫内膜间质肉瘤（14例）与330例平滑肌瘤（165例）、子宫内膜间质肉瘤（165例）的诊断年龄、体重指数、子宫体积进行比较。结果：受试者工作特征曲线显示NLR（>= 2.12）和血清CA-125水平（>= 27.5 U/ml）对子宫肉瘤术前诊断的最佳截断值，表明NLR对子宫肉瘤的术前诊断比血清CA-125水平更有效(敏感性74.5%比52.3%，特异性70.3%比50.5%，阳性预测值29.5%比15.1%，阴性预测值94.3%比86.5%，准确率60.6%比49.6%,p
Background: Uterine sarcomas are rare among all uterine malignancies, and frequently misdiagnosed as benign uterine diseases such as leiomyoma and adenomyosis because of lack of feasible tools for the preoperative diagnosis. Although some studies have suggested the role of serum CA-125 levels for the preoperative diagnosis, the efficacy is controversial. Since malignancy is known to be associated with systemic inflammation which leads to hematological alteration, we compared the efficacy for the preoperative diagnosis of uterine sarcomas between the neutrophil to lymphocyte ratio (NLR) and serum CA-125 levels using a case-match comparison.Methods: From November 2004 to December 2008, 55 patients with carcinosarcoma (n = 21), leiomyosarcoma (n = 20) and endometrial stromal sarcoma (n = 14) were matched to 330 patients with leiomyoma (n = 165) and adenomyosis (n = 165) in terms of age at diagnosis, body mass index and uterine volume.Results: The receiver operating characteristic curve showed the best cut-off values of the NLR (>= 2.12) and serum CA-125 levels (>= 27.5 U/ml) for the preoperative diagnosis of uterine sarcomas, demonstrating that the NLR was more powerful for the preoperative diagnosis of uterine sarcomas than serum CA-125 levels (sensitivity, 74.5% vs. 52.3%; specificity, 70.3% vs. 50.5%; positive predictive value, 29.5% vs. 15.1%; negative predictive value, 94.3% vs. 86.5%; accuracy, 60.6% vs. 49.6%; p