Predictive value of hemogram parameters in malignant transformation of the endometrium in patients with different risk factors

• Published in: PloS one Vol. 18; no. 1; p. e0279224
• Main Authors: Firat, Aysun, Ercan, Aysegul, Mordeniz, Cengiz, Verit Atmaca, Fatma Ferda
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 10-01-2023; Public Library of Science (PLoS)
• Subjects: Adult; Age; Aged; Biology and Life Sciences; Blood; Blood platelets; Body mass index; Cancer; Carcinoma - pathology; Care and treatment; Chronology; Colorectal cancer; Cytokines; Diabetes mellitus; Diagnosis; Endometrial cancer; Endometrial Neoplasms - pathology; Endometrium; Endometrium - pathology; Estrogen; Estrogens; Female; Health aspects; Hematocrit; Hemoglobin; Hormone replacement therapy; Humans; Hyperplasia; Inflammation; Leukocytes (neutrophilic); Lymphocytes; Lymphocytes - pathology; Medical records; Medicine and Health Sciences; Menstruation; Middle Aged; Neutrophils; Neutrophils - pathology; Obesity; Parameters; Pathology; Platelets; Polycystic ovary syndrome; Polyps; Post-menopause; Prognosis; Retrospective Studies; Risk analysis; Risk Factors; Statistical analysis; Thrombocytosis; Transformation; Transformations; Tumors; Uterine cancer; Uterus; Womens health; Turkey
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0279224

To investigate whether the pretreatment hemogram parameters and their ratios can be used in predicting the endometrial transformation in patients with abnormal uterine bleeding.
Records of all patients who underwent an endometrial histopathological evaluation between 2011 and 2021 were investigated. Hemogram, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were analyzed. Chi square and Mann Whitney U tests were used for analysis. P<0.05 was considered statistically significant.
427 patients were included, of whom 117 were presented with endometrial hyperplasia without atypia (27.4%; mean age, 42±9.7; Group II), 70 with atypia (16.3%; mean age, 53.4±9; Group III), 102 with early endometrial cancer (EC) (23.8%; mean age, 63±7.8; Group IV) and 38 with advanced disease (8.8%; mean age, 63.3±10.5; Group V). Patients without pathology constituted the control group (23.4%; mean age, 42.2±9.5; Group I). Risk factors for atypia and carcinoma were determined as age, postmenopausal state, obesity, diabetes, and increased estrogen exposure (each, p<0.05). There was no significant difference in NLR and PLR (p>0.05). However, hemoglobin and hematocrit levels were higher in Groups IV and V (13.9 vs 13.1 mg/dL, and 39.1 vs 38.8%, respectively; p<0.01). Platelet value was significantly higher in Groups III to V (282x109/L, 283x109/L and 295x109/L; p<0.05, p<0.05 and p<0.01, respectively).
Our findings support the impact of inflammation on malign transformation from normal endometrial mucosa to atypia and carcinoma. NLR and PLR values showed no statistical difference. Instead, thrombocytosis may have a predictive role in EC.