The diagnostic value of systemic inflammatory response markers as predictors of epithelial ovarian cancer

Background: Early detection of ovarian neoplasms confers a better outcome and prognosis for patients. Although newer diagnostic modalities have been recently developed, the availability and accessibility of complete blood count parameters make it a convenient and cost-effective marker for malignancy. Objectives were to evaluate the diagnostic accuracy of pretreatment neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with late-stage epithelial ovarian malignancy at the University of Port Harcourt Teaching Hospital. Methods: A prospective analysis of fifty-seven women with histologic diagnosis of epithelial ovarian cancer who were managed at the University of Port Harcourt Teaching Hospital between January 1, 2018, and December 31, 2022, was conducted. A data collection form was used to obtain socio-demographic and clinico-pathological characteristics from the patients after informed consent was obtained. Pretreatment levels of NLR and PLR were determined from complete blood count. The Receiver Operating Characteristic (ROC) curve analysis was used to assess the predictive accuracy of the haematological parameters for late-stage epithelial ovarian cancer. Results: Higher values of NLR and PLR were significantly associated with the stage of ovarian cancer (p=0.001). The optimal cut-off points based on ROC curve analyses for NLR and PLR were found to be 2.6 (AUC=0.61, p>0.05), and 155.8 (AUC=0.62, p>0.05) respectively. However, none of the haematological parameters could be used as predictive markers for advanced-stage ovarian cancer in this study. Conclusions: Pretreatment NLR and PLR cannot be used as a stand-alone predictor of advanced ovarian cancer, and should be correlated with other clinical, laboratory and radiologic parameters.