Are Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios Associated with Endometrial Precancerous and Cancerous Lesions in Patients with Abnormal Uterine Bleeding?


Background: An easy, reproducible and simple marker is needed to estimate phase of endometrial pathologiclesions such as hyperplasia and endometrial cancer and distinguish from pathologically normal results. Wehere aimed to clarify associations among neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio(PLR), endometrial hyperplasia and cancer in patients with abnormal uterine bleeding. Materials and
Methods:Patients (n=161) who were admitted with abnormal uterine bleeding and the presence of endometrial cells oncervical cytology or thick endometrium were investigated. The study constituted of three groups accordingto pathologic diagnosis. Group 1 included endometrial precancerous lesions like hyperplasia (n=63), group 2included endometrial cancerous lesions (n=38) and group 3 was a pathologically normal group (n=60). Bloodsamples were obtained just before the curettage procedure and the NLR was defined as the absolute neutrophilcount divided by the absolute lymphocyte count; similarly, PLR was defined as the absolute platelet count dividedby the absolute lymphocyte count.
Results: The white blood cell count was significantly higher in patients withcancer than in those with hyperplasia (p=0.005). The platelet count and neutrophil to lymphocyte ratio weresignificantly higher in patients with cancer than in control patients, but there was significantly no differencebetween patients with hyperplasia and other groups (p=0.001 and p=0.025 respectively). PLR was significantlylower in control subjects than in other groups (p<0.001), but there was no significant difference between patientswith hyperplasia and those with cancer.
Conclusions: PLR was significantly lower in control subjects than inother groups. Thus both hyperplasia and cancer may be differentiated from pathologically normal patients byusing PLR. White blood cell count was significantly higher in patients with cancer than in those with hyperplasiaand pathologically normal patients. Therefore white blood cell count may be used for discriminate hyperplasia tocancer. By using multiple inflammation parameters, discrimination may be possible among endometrial cancer,endometrial precancerous lesions and pathologically normal patients.