ABSTRACT

BACKGROUND/AIMS

This study aims to investigate the preoperative diagnostic accuracy of systemic inflammatory response (SIR) markers, including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in discriminating borderline ovarian tumors (BOTs) from malignancy and, thereby, prevent over- or underdiagnosis in the management of BOTs and ovarian malignancy.

MATERIAL and METHODS

Medical records of 99 patients who underwent surgical treatment and had confirmed histopathologic diagnosis of primary malignant or BOT were retrospectively analyzed. The recommended cut-off values for preoperative NLR and PLR were determined using receiver operating characteristic. The associations of NLR and PLR with tumors’ malignancy potentials were analyzed using the Chi-square test or the Fisher’s exact test.

RESULTS

The mean NLR and PLR were significantly lower (p=0.002 and p=0.006, respectively) in BOTs group than in the epithelial ovarian carcinoma (EOC) group. Optimal cut-off points of NLR and PLR for discriminating BOTs and EOC group was 2.42 and 169.2, respectively. The likelihood of malignancy increased in group with NLR values >2.42 (p<0.001; OR, 2.36, 95%; CI, 1.19–4.68) and PLR values >169.2 (p<0.001; OR, 3.6, 95%; CI, 1.48–8.76). Most importantly, both NLR and PLR values were above the cut-off point, and the malignancy risk had a 12-fold increase (p<0.001; OR, 12.15, 95%; CI, 1.78–82.6).

CONCLUSION

This data will strengthen the discrimination of malignant tumors from BOTs and facilitate the decision-making on surgical radicality and may also be used in combination with imaging strategies, tumor markers, and frozen section to increase diagnostic accuracy.