Correlation Analysis Of NLR,PLR,MLR And CA125 With Diagnosis And Clinicopathological Characteristics Of Endometrial Cancer

Objective:Endometrial carcinoma is one of the most common malignant tumors in gynecology,and its incidence is increasing year by year in China.In recent years,it has been found that there is a close relationship between inflammation and tumor development and that peripheral blood inflammatory indicators are associated with the diagnosis,clinicopathological features,and prognosis of a variety of malignancies.By retrospectively analyzing the preoperative peripheral blood neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,monocyte-to-lymphocyte ratio,and CA125 levels of endometrial carcinoma patients and normal endometrium patients,the study investigated the diagnostic value of NLR,PLR,MLR,and CA125 on endometrial carcinoma and the correlation with clinicopathological features.Methods:Patients with endometrial carcinoma who were treated at Northern Jiangsu People’s Hospital(NJPH)from January 2016 to December 2020 were selected for this study,and the clinical data of the patients were retrospectively analyzed.After further screening by inclusion and exclusion criteria,170 patients were enrolled in the EC group.A total of 160 patients with normal endometrium confirmed by surgical pathology during the same period were selected as the control group in this study.In this study,the general data,laboratory data,and clinicopathological data of the study subjects were collected and recorded.The subjects’working curves and logistic regression equations were used to analyze the diagnostic values of NLR,PLR,MLR,and CA125 alone and in combination for endometrial carcinoma;the ROC curves were applied to determine the best critical values of NLR,PLR,MLR and CA125 for the diagnosis of EC in patients in the EC group.The clinicopathological characteristics of patients with endometrial carcinoma in different groups were analyzed according to the grouping of the best critical values.Results:1.The neutrophil count and platelet count of patients with preoperative endometrial carcinoma were higher than those of patients with normal endometrium.The difference was statistically significant(P<0.05).The levels of NLR,PLR,and CA125 in patients with preoperative endometrial carcinoma were higher than those in patients with normal endometrium.The difference was statistically significant(P<0.05).Comparing the monocyte count,lymphocyte count,and MLR levels between the two groups of patients,the differences were not statistically significant(P<0.05).2.The ROC curves yielded that the AUC values of NLR,PLR,MLR and CA125 alone for predicting endometrial carcinoma were 0.713,0.585,0.534 and 0.704,respectively;the best critical values were 2.05,123.14,0.19 and 22.4 U/mL,respectively;NLR and CA125 have certain diagnostic value for EC,while PLR and MLR have low diagnostic value for EC.3.NLR correlated with surgical pathological staging,histological grading,and depth of muscular infiltration in endometrial carcinoma(P<0.05).Patients in the high NLR group had later pathologic staging,tended to have low to moderate differentiation,and had deeper myxoid infiltration.PLR was associated with pathological surgical stage,histological grading,and cervical interstitial involvement in endometrial carcinoma(P<0.05).Patients in the high PLR group had later pathologic staging,tended to have low to moderate differentiation,and had high cervical involvement.CA125 correlated with surgical pathological staging,histological grading,and depth of myxoid infiltration in endometrial carcinoma(P<0.05).Patients in the high CA125 group had later pathologic staging,tended to have low to moderate differentiation,and had deeper myxoid infiltration.There was no significant correlation between MLR and endometrial carcinoma in terms of pathological type,pathological surgical stage,histological grade,depth of myxomatous infiltration,cervical interstitial involvement,and lymph node metastasis(P>0.05).4.Speraman’s correlation analysis showed that CA125 was positively correlated with NLR and PLR(P<0.001,P<0.05);NLR,PLR,and MLR were positively correlated between two(P<0.01).5.The AUC value of 0.761 for the combination of NLR,PLR,and MLR to predict endometrial carcinoma was higher than that of the three indicators alone,with a sensitivity of 0.700 and specificity of 0.679.The AUC value of 0.812 for the combined detection of endometrial carcinoma by the four indicators NLR,PLR,MLR combined with CA125 was significantly higher than the AUC value for the prediction of the three indicators alone and the combined detection of EC,with a sensitivity of 0.900 and specificity of 0.588.6.According to multivariate logistic analysis,the OR values of NLR,PLR,and CA125 were 2.546,1.012,1.150,P<0.05.Increased levels of NLR,PLR,and CA125 are independent predictors of endometrial cancer.Conclusion:1.Patients with endometrial carcinoma have high levels of NLR,PLR,and CA125,which are potential predictors of endometrial carcinoma as a simple,easy,noninvasive,and cost-effective biomarker.2.NLR and PLR are valuable for the diagnosis of endometrial carcinoma,and the combined diagnostic value of NLR,PLR,MLR,and CA125 is higher than that of the diagnosis alone.The combined diagnosis can improve the accuracy of the diagnosis of endometrial carcinoma.3.NLR and CA125 are positively correlated with late pathological staging,low to moderate differentiation,and depth of myxoid infiltration in EC patients.This is predictive of preoperative assessment of surgical pathologic staging,histologic grading,and the degree of myxomatous infiltration.PLR is positively correlated with late pathological staging,low to moderate differentiation,and degree of cervical involvement in EC patients.This is predictive of preoperative assessment of patients’ surgical pathologic stage,histologic grading,and interstitial cervical space involvement.4.Increased levels of NLR,PLR,and CA125 are independent predictors of endometrial cancer.