Application Of Neutrophils/lymphocytes Ratio In Preoperative Diagnosis Of Uterus Sarcomas

Objective: Uterine sarcoma is a kind of rare malignant tumor. Due to the lack of satisfactary tumor marker for the preoperative diagnosis of uterine sarcoma, it is often misdiagnosed as uterine benign diseases such as leiomyoma and adenomyosis , bringing a lot of difficulty to the standardized treatment of uterine sarcoma. It is known that malignant tumor is related to systemic inflammatory, which also cause blood picture changes related component change. This paper aims to discuss the application value of neutrophils/lymphocytes ratio in preoperative diagnosis of uterine sarcoma through the statistical analysis of the preoperative blood component changes between control groups and uterine sarcoma group.Methods: Collect the exact cases of uterine sarcoma, leiomyoma or adenomyosis in the gynecological ward of the first hospital affiliated of Dalian medical university from September 2003 to September 2010. Select 23 cases of uterine sarcoma as researched group, 49 cases of leiomyoma and 38 cases of adenomyosis as control group by strict screening standards. It is aimed to discuss the diagnosed capability of each value before operation by the comparison of preoperative blood components variation and the neutrophilic/lymphocytes ratio. And it also analyzes diagnosed capability of the ratio in different stage and different pathology style, also the relationship between the age and the ratio.Results: Compared with the control group, the change of researched group's white blood count, eosinophil count,eosinophilic count,basophils count,platelet count and lymphocyte count,Mononuclear cell count shows no big statistical difference (p > 0.01), The higher raise of neutrophils count and the ratio of neutrophils/lymphocytes in researched group shows big statistical difference (p < 0.01). Receiver operating characteristic curve (ROC curves) shows the correlation between the leukocyte count, neutrophils count, neutrophils/lymphocytes ratio and the diagnosis of uterine sarcoma (p < 0.01). Although lymphocyte does not show statistical significance in groups, its diagnosis ability is passable (AUC 0.82). Neutrophils/lymphocytes ratio is not so good compared with white blood count and diagnostic neutrophilic count on the sensitivity, but it has the best specificity (when the best when 4.24 how - off for, the sensitivity and specificity for 98.9% 60.9%).Conclusion: Neutrophils/lymphocytes ratio shows strong correlations with uterine sarcoma in diagnosis, which can be counted as a norm in preoperative supplementary diagnosis. When the ratio is equal to or bigger than 4.24, it can be counted as cut-off value for diagnosis.