The Value Of Neutrophils/Lymphocytes Ratio In Preoperative Diagnosis Of Vulvar Squamous Cell Carcinoma And Vulvar Intraepithelial Neoplasia

Objective:Due to the lack of ideal marker of vulvar squamous cell carcinoma and similar symptoms and signs,it is difficult to distinguish vulvar squamous cell carcinoma from vulvar intraepithelial neoplasia. The aim of our study is to discuss the value of neutrophils/lymphocytes ratio (NLR) in preoperative diagnosis of vulvar squamous cell carcinoma and vulvar intraepithelial neoplasia.Methods:Totally 105 cases of vulvar squamous cell carcinoma (group 1:VSCC) and 29 cases of squamous vulvar intraepithelial neoplasia (group 2:VIN) treated in Peking university medical hospital from June 2008 to July 2014 were retrospectively analyzed.81 patients without vulvar abnormalities were included as normal control (group 3). The diagnosed capability of preoperative blood components variation and neutrophils/lymphocytes ratio (NLR) before operation were evaluated.Results:The change of eosinophilic count、basophils count, mononuclear and lymphocyte count shows no statistical difference (p> 0.05)between group 1 and 2.The white blood count neutrophils count(7.65±2.57), neutrophils count(5.50±2.49)and the neutrophils/lymphocytes ratio(4.26±3.31)in group 1 is significantly higher than group2(WBC:5.79±1.83,neutrophils count:3.66±1.53,NLR: 2.6311.22)and group 3(WBC:6.46±1.92, neutrophils count:3.93±1.29,NLR:2.07 ±0.37) (p< 0.05).Receiver operating characteristic curve(ROC curves) shows the correlation between the neutrophils/lymphocytes ratio and the diagnosis of VSCC and VIN. It is the best when cut value was set at 2.01, under which the sensitivity and specificity was 82.9% and 64.3%,respevtively.Conclusion:Neutrophils/lymphocytes ratio shows correlations with vulvar squamous cell carcinoma and vulvar intraepithelial neoplasia in diagnosis. NLR was significantly higher in patients with cancer than in those with hyperplasia and normal people. By using this inflammation parameters, discrimination may be possible among vulvar squamous cell carcinoma, vulvar intraepithelial neoplasia. When the ratio is equal to or bigger than 2.01,it can be counted as cut-off value for diagnosis of vulvar cancer.