Home Usefulness of hematological parameters for differential diagnosis of endometriomas in adolescents/young adults and older women
Article
Licensed
Unlicensed Requires Authentication

Usefulness of hematological parameters for differential diagnosis of endometriomas in adolescents/young adults and older women

  • Berna Seckin EMAIL logo , Mete Can Ates , Ayse Kirbas and Huseyin Yesilyurt
Published/Copyright: September 26, 2018

Abstract

Background

Inflammatory processes have been considered to be involved in the pathogenesis of endometriosis. However, the predictive role of inflammatory hematological parameters in endometriosis is not clear. The aim of this study was to analyze the clinical value of hematologic markers in the differential diagnosis of endometriomas in younger and older reproductive age women.

Materials and methods

A retrospective chart review was done for 502 patients who underwent surgery: 267 with endometriomas (endometrioma group) and 235 with other benign adnexal cysts (control group). Patients were placed into subgroups as younger (adolescents/young adults, aged <25 years) and older (aged ≥25 years) women. Total and differential white blood cell count, neutrophil-to-lymphocyte ratio, platelet indices and platelet-to-lymphocyte ratio (PLR) were evaluated with receiver operating characteristic curve analysis for differential diagnosis of endometriomas.

Results

The mean serum levels of PLR, plateletcrit (PCT), platelet count and CA-125 (reference range below 35 IU/mL) were significantly higher in the endometrioma group (p < 0.001). The area under the curve (AUC) for CA-125 was 0.85 [95% confidence interval (CI), 0.82–0.88] (p < 0.001) for the entire group. However, platelet count, PLR, and PCT showed poor discriminative ability for detecting endometriomas with AUC values of 0.59 (95% CI, 0.55–0.65, p < 0.001), 0.58 (95% CI, 0.53–0.63, p = 0.002) and 0.61 (95% CI, 0.56–0.66, p < 0.001), respectively. In age-stratified analysis, these platelet indices had also low diagnostic performance in both age groups.

Conclusions

Hematologic markers do not adequately differentiate ovarian endometriomas from other benign cysts in neither adolescents/young adults nor older women.

Acknowledgments

There is no financial support and conflict of interest regarding in this article.

References

[1] Greene R, Stratton P, Cleary SD, Ballweg ML, Sinaii N. Diagnostic experience among 4,334 women reporting surgically diagnosed endometriosis. Fertil Steril. 2009;91(1):32–9.10.1016/j.fertnstert.2007.11.020Search in Google Scholar

[2] Redwine DB. Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease. Fertil Steril. 1999;72(2):310–5.10.1016/S0015-0282(99)00211-3Search in Google Scholar

[3] Barcz E, Milewski Ł, Dziunycz P, Kamiński P, Płoski R, Malejczyk J. Peritoneal cytokines and adhesion formation in endometriosis: an inverse association with vascular endothelial growth factor concentration. Fertil Steril. 2012;97(6):1380–6.e1.10.1016/j.fertnstert.2012.03.057Search in Google Scholar

[4] Barrier BF. Immunology of endometriosis. Clin Obstet Gynecol. 2010;53(2):397–402.10.1097/GRF.0b013e3181db7c33Search in Google Scholar

[5] Mettler L, Schollmeyer T, Lehmann-Willenbrock E, Schüppler U, Schmutzler A, Shukla D, et al. Accuracy of laparoscopic diagnosis of endometriosis. JSLS. 2003;7(1):15–8.10.1016/S1074-3804(03)80032-4Search in Google Scholar

[6] May KE, Conduit-Hulbert SA, Villar J, Kirtley S, Kennedy SH, Becker CM. Peripheral biomarkers of endometriosis: a systematic review. Hum Reprod Update. 2010;16(6):651–74.10.1093/humupd/dmq009Search in Google Scholar PubMed PubMed Central

[7] Nisenblat V, Bossuyt PM, Shaikh R, Farquhar C, Jordan V, Scheffers CS, et al. Blood biomarkers for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016;(5):CD012179.10.1002/14651858.CD012179Search in Google Scholar PubMed PubMed Central

[8] Cho S, Cho H, Nam A, Kim HY, Choi YS, Park KH, et al. Neutrophil-to-lymphocyte ratio as an adjunct to CA-125 for the diagnosis of endometriosis. Fertil Steril. 2008;90(6):2073–9.10.1016/j.fertnstert.2008.03.061Search in Google Scholar PubMed

[9] Yang H, Lang JH, Zhu L, Wang S, Sha GH, Zhang Y. Diagnostic value of the neutrophil-to-lymphocyte ratio and the combination of serum CA-125 for stages III and IV endometriosis. Chin Med J (Engl). 2013;126(11):2011–4.10.3760/cma.j.issn.0366-6999.20123569Search in Google Scholar

[10] Yavuzcan A, Cağlar M, Ustün Y, Dilbaz S, Ozdemir I, Yıldız E, et al. Evaluation of mean platelet volume, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in advanced stage endometriosis with endometrioma. J Turk Ger Gynecol Assoc. 2013;14(4):210–5.10.5152/jtgga.2013.55452Search in Google Scholar PubMed PubMed Central

[11] Kim SK, Park JY, Jee BC, Suh CS, Kim SH. Association of the neutrophil-to-lymphocyte ratio and CA 125 with the endometriosis score. Clin Exp Reprod Med. 2014;41(4):151–7.10.5653/cerm.2014.41.4.151Search in Google Scholar PubMed PubMed Central

[12] Avcioğlu SN, Altinkaya SÖ, Küçük M, Demircan-Sezer S, Yüksel H. Can platelet indices be new biomarkers for severe endometriosis? ISRN Obstet Gynecol. 2014;2014:713542.10.1155/2014/713542Search in Google Scholar

[13] Yang H, Zhu L, Wang S, Lang J, Xu T. Noninvasive diagnosis of moderate to severe endometriosis: the platelet-lymphocyte ratio cannot be a neoadjuvant biomarker for serum cancer antigen 125. J Minim Invasive Gynecol. 2015;22(3):373–7.10.1016/j.jmig.2013.06.003Search in Google Scholar

[14] Chmaj-Wierzchowska K, Kampioni M, Wilczak M, Sajdak S, Opala T. Novel markers in the diagnostics of endometriomas: urocortin, ghrelin, and leptin or leukocytes, fibrinogen, and CA-125? Taiwan J Obstet Gynecol. 2015;54(2):126–30.10.1016/j.tjog.2014.08.004Search in Google Scholar

[15] Tokmak A, Yildirim G, Öztaş E, Akar S, Erkenekli K, Gülşen P, et al. Use of neutrophil-to-lymphocyte ratio combined with CA-125 to distinguish endometriomas from other benign ovarian cysts. Reprod Sci. 2016;23(6):795–802.10.1177/1933719115620494Search in Google Scholar

[16] World HealthOrganization. Programming for adolescent health and development. Technical Report Series No. 886. Geneva, Switzerland: World Health Organization, 1999.Search in Google Scholar

[17] Mol BW, Bayram N, Lijmer JG, Wiegerinck MA, Bongers MY, van der Veen F, et al. The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis. Fertil Steril. 1998;70(6):1101–8.10.1016/S0015-0282(98)00355-0Search in Google Scholar

[18] Zahorec R. Ratio of neutrophil to lymphocyte counts–rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5–14.Search in Google Scholar

[19] Berbic M, Fraser IS. Regulatory T cells and other leukocytes in the pathogenesis of endometriosis. J Reprod Immunol. 2011;88(2):149–55.10.1016/j.jri.2010.11.004Search in Google Scholar PubMed

[20] Uslu AU, Küçük A, Şahin A, Ugan Y, Yılmaz R, Güngör T, et al. Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. Int J Rheum Dis. 2015;18(7):731–5.10.1111/1756-185X.12582Search in Google Scholar PubMed

[21] Işık M, Şahin H, Hüseyin E. New platelet indices as inflammatory parameters for patients with rheumatoid arthritis. Eur J Rheumatol. 2014;1(4):144–6.10.5152/eurjrheumatol.2014.140023Search in Google Scholar PubMed PubMed Central

[22] Du Y, Liu X, Guo SW. Platelets impair natural killer cell reactivity and function in endometriosis through multiple mechanisms. Hum Reprod. 2017;32(4):794–810.10.1093/humrep/dex014Search in Google Scholar PubMed

[23] Zhang Q, Liu X, Guo SW. Progressive development of endometriosis and its hindrance by anti-platelet treatment in mice with induced endometriosis. Reprod Biomed Online. 2017;34(2):124–36.10.1016/j.rbmo.2016.11.006Search in Google Scholar PubMed

[24] Janssen EB, Rijkers AC, Hoppenbrouwers K, Meuleman C, D’Hooghe TM. Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain: a systematic review. Hum Reprod Update. 2013;19(5):570–82.10.1093/humupd/dmt016Search in Google Scholar PubMed

[25] Smorgick N, As-Sanie S, Marsh CA, Smith YR, Quint EH. Advanced stage endometriosis in adolescents and young women. J Pediatr Adolesc Gynecol. 2014;27(6):320–3.10.1016/j.jpag.2013.12.010Search in Google Scholar PubMed

[26] Benagiano G, Bianchi P, Brosens I. Ovarian endometriomas in adolescents often represent active angiogenic disease requiring early diagnosis and careful management. Minerva Ginecol. 2017;69(1):100–7.10.23736/S0026-4784.16.03919-8Search in Google Scholar PubMed

[27] Gordts S, Puttemans P, Gordts S, Brosens I. Ovarian endometrioma in the adolescent: a plea for early-stage diagnosis and full surgical treatment. Gynecol Surg. 2015;12(1):21–30.10.1007/s10397-014-0877-xSearch in Google Scholar PubMed PubMed Central

[28] Fassbender A, Burney RO, O DF, D’Hooghe T, Giudice L. Update on biomarkers for the detection of endometriosis. Biomed Res Int. 2015;2015:130854.10.1155/2015/130854Search in Google Scholar PubMed PubMed Central

[29] Patel MD, Feldstein VA, Chen DC, Lipson SD, Filly RA. Endometriomas: diagnostic performance of US. Radiology. 1999;210(3):739–45.10.1148/radiology.210.3.r99fe61739Search in Google Scholar PubMed

[30] Dupuis CS, Kim YH. Ultrasonography of adnexal causes of acute pelvic pain in pre-menopausal non-pregnant women. Ultrasonography. 2015;34(4):258–67.10.14366/usg.15013Search in Google Scholar PubMed PubMed Central

Received: 2018-04-23
Accepted: 2018-06-05
Published Online: 2018-09-26

©2018 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Close-in-age exemption laws: focusing on the best interests of children and adolescents
  4. Review
  5. Literature review: nutritional factors influencing academic achievement in school age children
  6. Original Articles
  7. Appointed by young people – a qualitative study on young patients recruiting hospital staff in Denmark
  8. Child labor and mental health status of in-school adolescents in a municipal local government area of Lagos state, Nigeria
  9. Usefulness of hematological parameters for differential diagnosis of endometriomas in adolescents/young adults and older women
  10. Assessment of the WHO Health Promoting Schools Framework among schools in selected villages of rural Puducherry, South India – a mixed method study
  11. The development and psychometric evaluation of a new instrument to market healthy breakfast and snacks among adolescents
  12. Awareness of bicycle light use of young adults
  13. A brief study on the knowledge and choice of contraception methods in married adolescent girls
  14. Coverage of and compliance to iron supplementation under the National Iron Plus Initiative among reproductive age-group women in urban Puducherry – a cross-sectional study
  15. Adolescents’ smartphone use at night, sleep disturbance and depressive symptoms
  16. Prevalence and determinants of poor quality of sleep among adolescents in rural Puducherry, South India
  17. Health awareness, lifestyle and dietary behavior of university students in the northeast part of Bangladesh
  18. The effectiveness of group counseling on prenatal care knowledge and performance of pregnant adolescents in a Kurdish region of Iran
  19. High adenovirus 36 seroprevalence among a population of Hispanic American youth
  20. Development and psychometric properties of the female adolescents’ sexual reproductive self-care scale
  21. Decide Now, Buy Marlboro”: Examining the influence and appeal of Marlboro’s new brand architecture among Filipino adolescents
  22. Knowledge, attitude and practice of cigarette smoking among senior secondary school students in Depok, Indonesia
  23. Factors associated with knowledge of where to access health care among youth in juvenile detention: a mixed methods study
  24. Association between a vegetarian diet and emotional symptoms: a cross-sectional study among adolescents in four developing countries
  25. A prospective 1-year study on load reduction of school backpacks shows reversible changes of body posture in schoolchildren
  26. Level, motivation and barriers to participate in physical activity among late adolescents in Puducherry
  27. A pilot study to improve sugar and water consumption in Maltese school children
  28. Deep venous thrombosis of lower limbs in adolescents: a study in a tertiary hospital
  29. Prevalence and determinants of condom use among male adolescents in Indonesia
  30. Iranian mothers’ needs for reproductive health education of their adolescent daughters: a qualitative study
  31. Short Communication
  32. Psychosocial determinants of stress among adolescents in an urban slum in a city of Western Maharashtra: a cross-sectional study
Downloaded on 30.10.2025 from https://www.degruyterbrill.com/document/doi/10.1515/ijamh-2018-0078/html
Scroll to top button