Diagnostic Value of Ultrasound Associated with Serum NLR, PLR, MLR and CA125 for Endometrial Carcinoma

Abstract

Background: Overall mortality of endometrial carcinoma (EC) has been increasing. Therefore, the correct preoperative diagnosis and accurate staging of EC are of great significance. Objective: This study aims to explore the diagnostic value of ultrasound associated with serum ratios of neutrophils to lymphocytes (NLR), platelets to lymphocytes (PLR), monocytes to lymphocytes (MLR) and carbohydrate antigen 125 (CA125) for endometrial carcinoma (EC). Methods: From 2018 to 2020, 104 patients with suspected EC diagnosed by ultrasound from the Affiliated Hospital of Sichuan Medical College were enrolled. All patients were examined by routine ultrasound, serum tumor markers CA125 and serum levels of NLR, PLR and MLR before operation. The size, boundary, internal echo and internal blood flow of the focus were recorded in detail. The correlation between NLR, PLR, MLR, CA125 and the occurrence of EC was analyzed by logistic regression. The receiver operating curve (ROC) and area under curve (AUC) were employed to evaluate the sensitivity and specificity of NLR, PLR, MLR, CA125 associated with ultrasound for diagnosing EC. Results: Among the 104 suspected cases, 64 were EC patients. The growth site, lesion shape and lesion range of 50% of the cancer foci were shown more clearly than those before radiography. There was a significant difference between high and low levels of NLR for surgical and pathological stages, histological types and myometrial invasion depth (p < 0.05). There was a significant difference between high and low levels of PLR for surgical and pathological stages, histological types and cervical involvement (p < 0.05). There was a significant difference between high and low levels of CA125 for surgical and pathological stages, histological types and depth of myometrial invasion (p < 0.05). Elevated levels of NLR, PLR, and CA125 were independent predictors of EC based on multivariate logistic regression analysis. ROC curve analysis revealed that the AUC value of ultrasound examination combined with NLR, PLR, MLR and CA125 for EC diagnosis was higher than other indexes. Conclusions: The diagnostic value of NLR, PLR, MLR and CA125 associated with ultrasound for EC is higher than ultrasound alone.