Role of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Prediction of Endometrial Hyperplasia and Endometrial Cancer

Abstract

Endometrial cancer is the most common gynecological cancer, about one third of endometrial hyperplasia with atypia progress to cancer. Malignant and premalignant lesions of the endometrium cause abnormal uterine bleeding or postmenopausal bleeding, Endometrial biopsy by Dilation and curettage (D&C) is an effective diagnostic step in evaluation of abnormal uterinebleeding and for the diagnosis of endometrial pathologies, however, the accuracy of this method for diagnosis of endometrial hyperplasia and carcinoma depends on the procedure, it does not sample the entire endometrial cavity and may miss the endometrial diseases in the corneal site of endometrial lining.Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are non-specific markers of inflammation. They play a crucial role in immunity including cancer-related inflammation. These hematological markers may be used as routine work with other diagnostic tool as D&C biopsy and transvaginal ultrasonography in abnormal uterine bleeding to identify patients with cancer and endometrial hyperplasia.Inflammation and immunogenesis are important for cancer progression and metastasis. Cancer-related inflammation has been hypothesized to increase the risk of tumor development and angiogenesis. Tumor associated inflammatory response is composed of inflammatory cells and inflammatory mediators. They often manifest as neutrophilia, thrombocytosis and relative lymphocytopenia. Endometrial hyperplasia (EH) occurs as a result of long time estrogen exposure with high risk of development endometrial cancer in patient with atypical endometrial hyperplasia. The role of inflammation in the development of cancer is of great scientific and public health interest and has drawn much attention of late.