Combined "Platelet-to-lymphocyte ratio and CA125" may be promising predictor for adhesions

Could surgeons be aware of adhesions in endometriosis patients preoperatively ?

Key Points

Highlights:

• Endometriotic adhesions are troublesome in surgical interventions:
• Adhesions may result in complications (injury to the pelvic vasculature-bladder- bowel), and increase the risk of late events (bowel obstruction, pelvic pain) and recurrences.

Importance:

• Assessment of endometriotic adhesions is highly important for adequate pre-operative preparation for selecting appropriate procedures.
• There is yet no dependable pre-operative clinical tool for assessing endometriotic adhesions.

What’s done here:

• A retrospective analysis of clinical data and blood count parameters was performed:
• A group of 145 patients with endometriosis that was confirmed by histopathological examination was selected.
• Data was compared to another group of 127 patients with benign ovarian tumors other than endometriosis.

Key results:

• The combined level of the "platelet-to-lymphocyte ratio and CA125" was significantly higher in patients with endometriosis than those with other benign ovarian masses.
• Besides, this combined marker was positively correlated with the severity of pelvic adhesions revealing its potential prediction in patients with endometriosis. 

Lay Summary

Drs. Guo & Zhang from the Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China published their manuscript on the importance of combined "platelet-to-lymphocyte ratio and CA125 level" as a biomarker of endometriosis in a recent issue of the journal “Frontiers ın Oncology”.

Currently, endometriosis is accepted as a local and systemic inflammatory disease even with tumor-like biological behaviors, including invasion, adhesion, recurrence, and metastasis. Unfortunately, adhesions may yield difficulties in surgical management, such as injury to the pelvic vasculature, bladder, and bowel, increasing the risk of surgical complications, such as bowel obstruction, chronic pelvic pain, and recurrences.

Preoperative evaluation of these adhesions is highly important for adequate pre-operative preparation and selection of procedures in order to prevent organ damage during the procedure and planning follow-up. There is not any reliable pre-operative clinical tool in assessing endometriotic adhesions yet.

The authors have analyzed the clinical data and blood count parameters between a group of 145 patients with endometriosis confirmed by histopathological examination and compared the data with another group of 127 patients with benign ovarian tumors other than endometriosis.

The mean level of CA125 and the platelet-to-lymphocyte ratio in endometriosis patients were significantly higher than those in benign ovarian mass patients. It was also found that the severity of adhesion in endometriosis was positively correlated with the platelet-lymphocyte-ratio and combined marker. 

The authors conclude that this combined marker was not only positively correlated with pelvic adhesion but also showed a greater diagnostic value and specificity than CA125 alone. The combined marker could be a potential biomarker yielding an important role in diagnosing and evaluating adhesion in endometriosis.

Research Source: https://pubmed.ncbi.nlm.nih.gov/35800055/