Are blood parameters assessed before taking frozen sections useful in gynecological oncology?
A novel index in the prediction of gynecological malignancy
Keywords:Frozen section, Gynecological oncology, Complete blood count, Lymphocyte, Neutrophil
Background/Aim: Inflammatory processes are often implicated in oncology, and inflammatory markers and indices have been much studied in this context. In gynecological surgery, frozen sections have proven valuable in decision-making. Here we aim to identify laboratory parameters that correlate with frozen section results and thus develop new indices in neoplastic decision-making.
Methods: In this retrospective cross-sectional study at Bursa Yüksek İhtisas Training and Research Hospital, we evaluated 139 patients diagnosed with adnexal mass and endometrial intraepithelial neoplasia. We divided the patients whose frozen sections were reported as malignant, borderline, or benign into three groups and compared the pre-operative complete blood parameters.
Results: The mean age of our patients was 57.3 (11.5) years, and frozen section reports were benign in 33 (23.7%), borderline in 43 (30.9%), and malignant in 63 (45.3%) patients. The mean corpuscular volume and mean platelet volume values were different, and this difference was significant between borderline and malignant groups in post-hoc analyses (P = 0.04 and P = 0.03, respectively). While the percentage of lymphocytes was lower in malignant groups, the percentage of neutrophils was higher (P = 0.01 and P = 0.03, respectively). According to post-hoc analysis, the percentage of neutrophils differs between benign and malignant groups (P = 0.05). The difference in lymphocyte percentage was significant between benign-borderline and benign-malignant groups (P = 0.02, P = 0.05; respectively). The blood neutrophil/lymphocyte ratio was higher in the malignant groups compared to the other two groups (P = 0.02). We used the Multi Linear Regression Analysis method to analyze the factors that play a role in predicting the frozen outcome as malignant. Accordingly, the model with the best performance used lymphocyte percentage, neutrophil/lymphocyte ratio, and Ca-125 parameters (P = 0.03).
Conclusion: This study indicates that inflammatory markers may give a clue about the character of the neoplastic mass before oncology surgery. Thus, we can make new contributions to the surgical and clinical approach in the literature by developing new malignancy indices.
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