Breast cancer is the most common malignant disease among women, constituting around a quarter of all cancers in women worldwide. This type of cancer is mainly affected by genetic, environmental, and lifestyle factors such as nutrition and physical activity. A retrospective study including 192 women with breast cancer was performed for six years (from 2015 to 2021). We investigated the relationship between indirect hematological parameters, neutrophil-to lymphocyte ratio – NLR, plateletsto-lymphocyte ratio – PLR, systemic immune-inflammation index – SII and the treatment outcome. Additionally, we also followed the overall survival (OS) rate. The obtained results report assessed parameters before and after surgical intervention. Of importance is to emphasize that at a cut-off value of 2.65 (P = 0.001) and 3.30 (P < 0.001), a decline in the NLR value was noticed after surgical removal of the breast cancer. The same decrease was observed for SII after surgery (P < 0.001). Through the study, SII has been shown to be a more relevant parameter compared to NLR and PLR. The study outcome recommends the cut-off value of 2.65 as the optimal for NLR in predicting the effectiveness and successfulness of the surgical procedure.

Introduction: The markers of inflammations are a significant predictor of postoperative outcome after colorectal cancer surgery. along with leukocytes, c-reactive protein (crp), procalcitonin (pct) and neutrophil/lymphocyte ratio (nlr) we tried to test the role of immature granulocytes (ig) counts and trends in the postoperative period. Methods: We recorded matched three patient according to their sex, age, and tumor localization who had an uneventful recovery with three patients who had an anastomotic leak required reoperation. We obtained the ig count with every complete blood count and correlated these with crp, pct, nlr. for the best prediction we calculated the potential Zagreb score by adding 1 point for elevated nlr ratio for more than 75%, minimally three consecutively elevated % ig, doubling of immature granulocytes relative value to absolute neutrophils count ratio (ig ratio) and immature granulocytes relative value to leucocytes count ratio (it ratio) at three consecutive time points. results and conclusion: potential Zagreb score seems to predict the need for reoperation in time. Herein we introduce its concept, and we plan the retrospective study to test its feasibility and precision.

This study aimed to identify and quantify the clinical significance of the HE4 and ROMA index in patients with an adnexal tumour. We recruited 159 women and the HE4 and CA125 were measured with an electrochemiluminescence immunoassay in the sera. We used the Kolmogorov-Smirnov test, Mann-Whitney's test and logistic regression to interpret the data. In the premenopausal group (n = 57), the ROC analysis (with cut-off: 86.1 pmol/L for HE4; 40.7 U/L for CA125 and 21.9% for ROMA) demonstrated the superior prognostic potential of those markers when the higher cut-offs used are compared to producers. The AUC for HE4/CA125/ROMA were 0.846/0.867/0.846, respectively. The HE4/ROMA showed 85.7% sensitivity and 94% specificity. In the postmenopausal group (n = 102), the ROC analysis cut-off values were: 99.8 pmol/L for HE4; 45.8 U/L for CA125 and 38.4% for ROMA. AUC for HE4/CA125/ROMA were 0.928/0.899/0.927, respectively. HE4 had an 86.1% sensitivity at 92.4% specificity, while ROMA showed an 88.9% sensitivity at a 90.9% specificity. Impact Statement What is already known on this subject? The incidence of ovarian cancer has been increasing, despite the improvement of diagnostic, operative and therapeutic procedures. As a part of the multiparametric approach, the HE4 and ROMA index improve the diagnostic sensitivity and specificity of CA125 in the detection of ovarian cancer. What the results of this study add? The evaluation of HE4 and ROMA efficacy in the preoperative stratification was made by logistic regression analysis. The better prognostic potential of ROMA index, in patients with present adnexal mass, was obtained using our higher cut-offs for the ROMA index (21.9% for premenopausal and 38.4% for postmenopausal) in comparison to the producer's (11.7% for premenopausal and 29.9% for postmenopausal). The HE4 and ROMA index had 14.29 +LR, 0.15 -LR, 67% PPV and 97.9% NPV in the premenopausal patients. In the postmenopausal group, the HE4 had 11.37 +LR, 0.15 -LR, 75.6% PPV and 92.4% NPV, the ROMA showed 9.78 +LR, 0.12 -LR, 91.2% PPV and 95.2% NPV. What the implications are of these findings for clinical practice and/or further research? Application of a higher cut-off for HE4/CA125/ROMA index can significantly reduce the percentage of FP and FN in the preoperative stratification of ovarian cancer and justify speculations about this subject in the future.