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Diagnostic value of serum D‐dimer, CA 125, and neutrophil‐to‐lymphocyte ratio in differentiating ovarian cancer and endometriosis
Author(s) -
Chen Lifeng,
Wang Xinyan,
Shu Jing,
Xu Sheng,
Wu Qing,
Yu Yan
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12949
Subject(s) - medicine , ovarian cancer , gastroenterology , d dimer , white blood cell , endometriosis , neutrophil to lymphocyte ratio , receiver operating characteristic , confidence interval , area under the curve , cancer antigen , absolute neutrophil count , platelet , lymphocyte , cancer , neutropenia , toxicity
Objective To assess the utility of hematologic, inflammatory, and immunologic biomarkers for differentiating between ovarian cancer and endometriosis. Methods Data were retrospectively reviewed from women diagnosed with ovarian cancer and endometriosis after ovarian cyst surgery in Zhejiang, China, 2014–2016. Serologic and hematologic biomarkers, including white blood cell count, lymphocyte count, neutrophil count, red blood cell count, hemoglobin, platelets, and D‐dimer, albumin, globulin, cancer antigen 125 ( CA 125) and CA 199 serum levels recorded pre‐operatively were assessed by ROC curve and logistic regression analysis. Results Overall, 49 women were diagnosed with ovarian cancer and 192 with endometriosis. For predicting ovarian cancer, the area under the curve ( AUC ) was 0.96 (95% confidence interval [ CI ], 0.94–0.99); sensitivity, 93.2%; specificity, 87.5%) for log(D‐dimer), 0.95 (95% CI , 0.91–0.98; sensitivity, 81.3%; specificity, 96.3%) for log( CA 125), and 0.92 (95% CI , 0.86–0.98; sensitivity, 92.6%; specificity, 79.2%) for neutrophil‐to‐lymphocyte ratio ( NLR ). The AUC for the combination of D‐dimer, NLR , and CA 125 was 0.96 (95% CI , 0.94–0.99; sensitivity, 91.6%; specificity, 89.6%). Conclusion Serum D‐dimer, NLR , and CA 125 were found to be potential diagnostic factors for ovarian cancer. Combined measurement of D‐dimer, NLR , and CA 125 might offer a convenient screening method.