Relationship Between Preoperative Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios in the Probable Diagnosis of Malignant or Borderline Ovarian Tumors

Abstract Background: The purpose of this study was to investigate whether neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) can be supplementary tools to differentiate benign, borderline, and malignant ovarian tumors.Methods: This retrospective study reviewed the postoperative histopathology in patients with ovarian tumors (220 benign, 59 borderline, and 228 malignant). White blood cell, platelet, neutrophil and lymphocyte counts, percentage of neutrophils and lymphocytes, calculated NLR and PLR were analyzed between groups using complete blood count tests performed before surgery. Results: The platelet count and PLR in borderline ovarian tumors tended to be statistically close to benign ovarian tumors, while the neutrophil and lymphocyte count, NLR tended to be statistically close to malignancy. The diagnostic cut-off value of NLR for differentiating between benign and borderline was 2.42, PLR for differentiating between borderline and malignancy was 140.96. When the NLR was 2.4 or higher, the odds ratio of borderline or malignant risk was 3.264. In the case of PLR, 140 or higher, the odds ratio of malignancy was 1.916. When both PLR and NLR were above each cut-off, the sensitivity of malignancy diagnosis was 51.5%, specificity was 77.0%. Conclusions: In the case of borderline ovarian tumors, the NLR was higher than benign and similarly tend to malignancy, but the PLR was lower than malignancy and similarly tend to benign. We suggest that the NLR and PLR can be used as a supplementary tool for diagnosing benign, borderline, and malignant ovarian tumors in addition to imaging diagnosis and tumor markers such as CA125.