Objective To investigate the potential utility of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), and fibrinogen-to-albumin ratio (FAR) in the diagnosis of endometrioid carcinoma (EEC). Additionally, to explore the correlation between these ratios and the clinicopathological characteristics of EEC.
Methods 1.113 patients with EECdiagnosed in our hospital from November 2018 to November 2023 were selected as the study group, and 113 patients with endometrial polyps in our hospital during the same period were selected as the control group. Both groups were confirmed by pathology. The differences of NLR, PLR, SIIand FAR in the pre-operation peripheral blood of patients in the two groups were analyzed, and the value of individual indicators in diagnosis of EEC was evaluated using the Receiver Operating Characteristic (ROC) curve. 2. 147 patients of EEC with complete clinic-pathological data were divided into groups according to postoperative FIGO stage, histological grade, depth of muscle invasion, presence or absence of lymph-vascular space invasion (LVSI) and lymph node metastasis (LNM). The correlations between NLR, PLR, SII, FAR and different clinicopathological characteristics were analyzed.
Results 1. The levels of NLR, SII and FAR in patients of EEC were significantly higher than those in patients with endometrial polyps (P<0.05). While PLR showed no significant difference between the two groups (P>0.05). The optimal cut-off values of NLR, SII, FAR were 1.650, 361.260 and 0.071. The area under the curve (AUC) were 0.621, 0.622 and 0.590. The sensitivity and specificity were 66.4%, 72.6%, 48.7% and 54.9%, 47.8%,70.8%. 2. Among 147 EEC patients, there were 130 (88.43%) cases in FIGOI+II stage and 17 (11.56%) cases in III+IV stage, 5 (3.40%) cases with LNM and 142 (96.59%) cases without LNM. Significant differences of NLR, PLR, SII were observed between different clinical stages and LNM status, while FAR only showed an advantage in clinical stage (P<0.05). However, NLR, PLR, SII and FAR showed no significant differences in histological grade, depth of myographic infiltration, and LVSI (P>0.05).
Conclusion As a simple and non-invasive preoperative hematological index, NLR, PLR and SII have certain predictive value for EEC. NLR, PLR, SII and FAR are closely correlated with the clinicopathologic features of EEC, may serve as potential discriminative biomarkers for the diagnosis and prognosis of EEC.