Preoperative Haematologic Markers for the Differentiation of Endometrial Cancer from Benign Endometrial Lesions in Postmenopausal Patients with Endometrial Masses

Yong Jung Song,1,2 Hwi Gon Kim,1,2 Hyung Joon Yoon,1 Kyung Un Choi,3 Dong Soo Suh,1,* Ki Hyung Kim1,* 1Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, South Korea; 2Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea; 3Department of Pathology, Pusan National University School of Medicine, Busan, South Korea*These authors contributed equally to this workCorrespondence: Ki Hyung Kim, Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, 49241, South Korea, Tel +82-51-240-7287, Fax +82-51-248-2384, Email ghkim@pusan.ac.krPurpose: The diagnostic value of preoperative hematological changes in endometrial cancer (EC) remains unclear. This study aimed to assess the role of preoperative hematologic parameters in differentiating EC from benign endometrial lesions in postmenopausal women with endometrial masses.Methods: Preoperative laboratory variables were retrospectively reviewed in patients with malignant or benign endometrial lesions, and the significance of intergroup differences was assessed. Receiver operating characteristic curves were used to analyze the optimal cut-off values for each variable. Logistic regression analysis was used to identify the variables predicting the presence of endometrial malignancy.Results: Preoperative laboratory variables of 176 patients (84 EC and 92 benign lesions) with endometrial masses were analyzed. Significant differences were observed between malignant and benign lesions in terms of WBC count, ANC, MCV, MPV, PDW, CA125, NLR, PMR, LMR, and SII (P < 0.05). Multivariate analyses showed that a high WBC count, high ANC, low MCV, low MPV, low PDW, high CA125, high NLR, high PMR, high LMR, and high SII independently predicted the presence of endometrial malignancy.Conclusion: The combination markers, MPV+PDW+NLR, had good discriminatory power for the presence of malignancy (AUC 0.797). Our results suggest that hematologic markers could be useful for the differentiation of malignant and benign endometrial lesions.Keywords: endometrial cancer, differentiation, hematologic parameters, combination markers