Cl inical significance of neutrophit/lymphocyte ratio in differential diagnosis before operation between vulvar squam ous cell carcinoma and vulvar intraepithelial neoplasia

LIU Wanqing; LAI Cengzhen; WEI Qin

doi:10.3969/j.issn.1002-7386.2017.23.006

Abstract：Objective To explore the clinical significance of neutrophil /lymphocyte ratio (NLR ) in differential diagnosis before operation between vulvar squamous cell carcinoma ( VSCC ) and vulvar intraepithelial neoplasia ( VIN ) . M ethods A retrospective analysis was carried out about the clinical data of 132 patients with VSCC and 34 patients with VIN who were admitted and treated in our hospital from January 2012 to August 2016 .These patients were divided into VSCC group (n=132) and VIN group (n=340),moreover,the other 100 healthy subjects were served as control group .The patient's symptoms and signs ,preoperative peripheral complete blood cell count and NLR were analyzed and compared among the three groups.Moreover the single factor analysis and ROC curve were used to analyze the cilical value of preoperative NLR in differential diagnosis between VSCC and VIN .Results A total of 266 subjects were included and their data were complete . The average age and delivery times in VSCC group were significantly higher than those in VIN group (P<0.05).The lesions size in VSCC group was bigger than that in VIN group (46.1 ±2.69cm vs 2.30 ±1.12cm,P<0.05).The white blood cell count (7.57 ±2.61),neutrophils count (5.61 ±2.50), NLR (4.76 ±3.36) in VSCC group were significantly higher than those in VIN group (WBC:5.98 ±1.82,neutrophils count:4.23 ±1.59,NLR:2.65 ±1.12,P<0.05).The lymphocyte counts in VSCC group (1.62 ±0.65) and VIN group (1.78 ±0.66) were obviously higher than those (2.13 ±0.91)in control group (P<0.05).However there were no significant differences in eosinophilic count ,basophils count,mononuclear and lymphocyte count between the two groups (P>0.05).The NLR in VSCC group and VIN group was closely retaled with vulvar lesion size (P<0.05).The best cut value of NLR was 2.98,the area under curve was 0.749 ,moreover, the sensitivity and specificity of differential diagnosis between VSCC and VIN were 68.9%, 82.4%, respectively.Conclusion The NLR can be regarded as a preoperative auxiliary diagnosis method in differential diagnosis between VSCC and VIN .Moreover NLR 2.98 should be used as cut-off value of differential diagnosis between VSCC and VIN .