The Role of Neutrophil/Lymphocyte Ratio, Platelet/Lymphocyte Ratio and Mean Platelet Volume in Diagnosis of Hydrosalpinx
Abstract
Aim: It is very important to uncover the relationship between Hydrosalpinx, which occurs as a result of chronic-inflammatory-processes, and inflammatory markers. Our study aimed to investigate the role of Neutrophil/Lymphocyte Ratio(NLR), Platelet/Lymphocyte Ratio(PLR), and Mean Platelet Volume(MPV) values in the diagnosis of patients who had Hydrosalpinx.
Materials and Methods: Our study included 349 patients, who applied to our clinic between March 2018-June 2023, were diagnosed with primary or secondary infertility, and for this reason underwent Hysterosalpingography. A total of 89 patients who had Hydrosalpinx and 260 patients who did not have Hydrosalpinx were divided into 2 groups, and the demographic, clinical data were compared retrospectively.
Results: Neutrophil and Platelet levels were found to be significantly higher in the Hydrosalpinx-group than the control group(p:0.000).The presence of Hydrosalpinx was found to be significantly higher in patients who were diagnosed with secondary infertility(p:0.000).Neutrophil and Platelet levels were significantly higher in the bilateral-Hydrosalpinx-group than the unilateral-Hydrosalpinx-group(p:0.036,p:0.012, respectively). The NLR and PLR were found to be significantly higher in the bilateral-Hydrosalpinx-group than the unilateral–Hydrosalpinx-group(p:0.038,p:0.009, respectively). MPV were found to be significantly lower in the bilateral-Hydrosalpinx-group than the unilateral-Hydrosalpinx-group(p:0.011).
Conclusion: The findings of our study support the literature data on the relationship between NLR,PLR,MPV, and chronic inflammatory processes. These markers deserve to be evaluated again and again in prospective and controlled studies, in which they will be considered together with clinical findings, to investigate their ability to predict the diagnosis of Hydrosalpinx, its severity, and clinical outcomes in infertile patients.
Keywords
hydrosalpinx infertility mean platelet volume neutrophil/lymphocyte ratio platelet/lymphocyte ratio
References
- Strandell, A. The patient with hydrosalpinx. Assisted Reproduction Techniques: Challenges and Management Options. 2021;147-152.
- Hao, H. J., Wang, Z. H., Feng, L., Zhao, X. L., & Chen, X. Which patients with hydrosalpinx will benefit more from reproductive surgery to improve natural pregnancy outcomes?: A systematic review and meta-analysis. Medicine.2023; 102(8).
- Pérez‐Milán, F., Caballero‐Campo, M., Carrera‐Roig, M., Moratalla‐Bartolomé, E., Domínguez‐Arroyo, J. A., Alcázar‐Zambrano, J. L., ... & Carugno, J. A. Systematic review and network meta‐analysis of hydrosalpinx treatment before in vitro fertilization.Ultrasound in Obstetrics & Gynecology.2024;5.
- Atlıhan U, Deründere Ü. Results Of Spontaneous Pregnancy After Hysterosalpingography İn Patients With Unexplained Infertility. Journal of Pharmaceutical Negative Results. 2022;13(5):1847-1852.
- Yang, J. J., & Chapman, M. What are the risks associated with lipiodol hysterosalpingography? A literature review. Radiography. 2023;29(6):1041-1045.
- Wang Q, Sun Y, Fan R, Wang M, Ren C, Jiang A, Yang T. Role of inflammatory factors in the etiology and treatment of recurrent implantation failure.Reproductive Biology. 2022;22(4).
- Qiu X, Wang Q, Zhang Y, Zhao Q, Jiang Z, Zhou L. Prognostic Value of Neutrophils-to-Lymphocytes Ratio and Platelets-to-Lymphocytes Ratio in Sepsis Patients With Lymphopenia. Biomarker Insights. 2024;19(1).
- Djordjevic D, Rondovic G, Surbatovic M, Stanojevic I, Udovicic I, Andjelic T, et al. Neutrophil-to-lymphocyte ratio, monocyte-to lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume-to-platelet count ratio as biomarkers in critically ill and injured patients: which ratio to choose to predict outcome and nature of bacteremia? Mediators Inflamm. 2018;7(15).
- Diem S, Schmid S, Krapf M, Flatz L, Born D, Jochum W, et al. Neutrophil-to-lymphocyte ratio (nlr) and platelet-to-lymphocyte ratio (plr) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab. Lung Cancer. 2017;11(1):176-81.
- Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019;4(17).
- Handtke, S., & Thiele, T. Large and small platelets—(When) do they differ?. Journal of Thrombosis and Haemostasis. 2020;18(6):1256-1267.
- Repsold L, Joubert AM. Platelet Function, Role in Thrombosis, Inflammation, and Consequences in Chronic Myeloproliferative Disorders. Cells. 2021; 10(11):3034.
- Afsar N, Afroze IA, Tahniath H, Abid Z. Role of mean platelet volume as an adjunct in evaluation of acute inflammation. Annals of Pathology and Laboratory Medicine 2017;4(4):466-469
- M Nissen, V Sander, P Rogge, M Alrefai, R-B Tröbs. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio Might Predict Pediatric Ovarian Torsion: A Single-Institution Experience and Review of the Literature. Journal of Pediatric and Adolescent Gynecology.2021;34(3):334-340.
- Kang Q, Li W, Yu N, Fan L, Zhang Y, Sha M, et al. Predictive role of neutrophil-to-lymphocyte ratio in preeclampsia: A meta-analysis including 3982 patients. Pregnancy Hypertension.2020;20(4):111-118.
- Özer S, Yılmaz R, Sönmezgöz E, Karaaslan E, Taşkın S, Bütün İ, Demir O. Simple markers for subclinical inflammation in patients with Familial Mediterranean Fever. Med Sci Monit. 2015;21(1):298-303.
- Boyraz I, Koç B, Boyacı A, Tutoğlu A, Sarman H, Ozkan H. Ratio of neutrophil/lymphocyte and platelet/lympho cyte in patient with ankylosing spondylitis that are treating with anti-TNF. Int J Clin Exp Med 2014;7(9):2912-5
- Buonacera, A., Stancanelli, B., Colaci, M., & Malatino, L. Neutrophil to lymphocyte ratio: an emerging marker of the relationships between the immune system and diseases. International journal of molecular sciences.2022;23(7).
- Kolaczkowska E, Kubes P. Neutrophil recruitment and function in health and inflammation. Nat Rev Immunol 2013;13(3):159-75.
- Duan Y, Zhou Y, Peng Y, Shi X, Peng C. Inflammatory Markers in Women with Infertility: A Cross-Sectional Study. Inflammatory Markers in Women with Infertility: A Cross-Sectional Study. International Journal of General Medicine.2023;27(16):1113-1121.
- Tola EN. The association between in vitro fertilization outcome and the inflammatory markers of complete blood count among nonobese unexplained infertile couples. Taiwanese Journal of Obstetrics and Gynecology.2018;57(2):289-294.
- Yang H, Zhu L, Wang S, Lang J, Xu T. Noninvasive Diagnosis of Moderate to Severe Endometriosis: The Platelet-Lymphocyte Ratio Cannot Be a Neoadjuvant Biomarker for Serum Cancer Antigen 125. Journal of Minimally Invasive Gynecology. 2015;22(3):373-377.
- Avcioğlu SN, Altinkaya SÖ, Küçük M, Demircan-Sezer S, Yüksel H. Can Platelet Indices Be New Biomarkers for Severe Endometriosis? International Scholarly Research Notices.2014;26(3):
- Li L, Yu J, Zhou Z. Mean platelet volume and polycystic ovary syndrome: a systematic review and meta-analysis. Journal of International Medical Research. 2022;50(1).
- Al Subhi T, Al Jashnmi RN, Al Khaduri M, Gowri V. Prevalence of tubal obstruction in the hysterosalpingogram of women with primary and secondary infertility. J Reprod Infertil. 2013;14(4):214-216.
- Benksim A, Elkhoudri N, Addi RA, Baali A, Cherkaoui M. Difference between Primary and Secondary Infertility in Morocco: Frequencies and Associated Factors. Int J Fertil Steril. 2018;12(2):142-146.
- Abebe MS, Afework M, Abaynew Y. Primary and secondary infertility in Africa: systematic review with meta-analysis. Fertil Res Pract. 2020;6(1).
- Ambildhuke K, Pajai S, Chimegave A, Mundhada R, Kabra P. A Review of Tubal Factors Affecting Fertility and its Management. Cureus. 2022;14(11)
- Elsharif, A. K., Mohamed, M. E. S., Nossair, W. S., & Fattah, M. T. A.. Relationship between Female Infertility and Pelvic Inflammatory Disease. European Journal of Molecular and Clinical Medicine.2021; 8(4):1007-1015.
- Seçkin KD, Karslı MF, Yücel B, Özköse B, Yıldırım D, Çetin BA & Aslan H. Neutrophil lymphocyte ratio, platelet lymphocyte ratio and mean platelet volume; which one is more predictive in the diagnosis of pelvic inflammatory disease? Gynecology Obstetrics & Reproductive Medicine.2015;21(3):150-154.
- Guo C, Zhang C. Platelet-to-Lymphocyte Ratio and CA125 Level as a Combined Biomarker for Diagnosing Endometriosis and Predicting Pelvic Adhesion Severity. Front Oncol. 2022;21(12).
- M. Hocaoglu, A. Turgut, E. Akdeniz, A. Usta, A.A. Ersahin, A. Karateke. Predictive value of neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio and mean platelet volume for pelvic inflammatory disease. Clin. Exp. Obstet. Gynecol. 2019;46(1):36–41.
Hidrosalpinks Tanısında Nötrofil/Lenfosit Oranı, Trombosit/Lenfosit Oranı ve Ortalama Trombosit Hacminin Rolü
Abstract
Amaç: Kronik inflamatuvar süreçlerin sonucu olarak ortaya çıkan hidrosalpinksin inflamatuvar markerlarla ilişkisinin ortaya koyulması oldukça önemlidir. Bu çalışmanın amacı hidrosalpinksli hastaların tanısında Nötrofil/lenfosit oranı, Platelet/lenfosit oranı ve Mean Platelet volume değerinin rolünü araştırmaktır. Gereç ve Yöntem: Çalışmamıza Mart 2018 – Haziran 2023 arasında polikliniğimize başvuran, primer veya sekonder infertilite tanısı koyulan ve bu nedenle Histerosalpingografi çekilen 349 hasta dahil edilmiştir. Çalışmada hidrosalpinks saptanan 89 hasta ile, saptanmayan 260 hasta iki gruba ayrıldı ve grupların demografik, klinik verileri retrospektif olarak karşılaştırıldı. Bulgular: Hidrosalpinks grubunda nötrofil düzeyi ve platelet düzeyi, kontrol grubuna göre anlamlı yüksek saptanmıştır (p:0.000). Sekonder infertilite tanılı hastalarda hidrosalpinks varlığı anlamlı yüksek saptanmıştır (p:0.000). Bilateral hidrosalpinks grubunda nötrofil düzeyi ve platelet düzeyi unilateral hidrosalpinks grubuna göre anlamlı yüksek saptanmıştır (p:0.036, p:0.012 sırasıyla). Bilateral hidrosalpinks grubunda nötrofil/lenfosit oranı ve platelet/lenfosit oranı, unilateral hidrosalpinks grubuna göre anlamlı yüksek saptanmıştır (p:0.038, p:0.009 sırasıyla). Bilateral hidrosalpinks grubunda mean platelet volüme düzeyi, unilateral hidrosalpinks grubuna göre anlamlı düşük saptanmıştır (p:0.011). Sonuç: Çalışmamızdaki bulgular Nötrofil/lenfosit oranı, Platelet/lenfosit oranı ve Mean Platelet volume ile kronik inflamatuar süreçler arasındaki ilişkiye dair önceki literatürü desteklemektedir. Bu belirteçlerin, infertil hastalarda, hidrosalpinks tanısını, hastalığın şiddetini ve klinik sonuçlarını tahmin etme yeteneklerini araştırmak için, klinik bulgularla birlikte ele alındıkları prospektif, kontrollü çalışmalarda yeniden değerlendirilmeyi hak etmektedir.
Keywords
hidrosalpinks infertilite ortalama trombosit hacmi nötrofil/lenfosit oranı platelet/lenfosit oranı
References
- Strandell, A. The patient with hydrosalpinx. Assisted Reproduction Techniques: Challenges and Management Options. 2021;147-152.
- Hao, H. J., Wang, Z. H., Feng, L., Zhao, X. L., & Chen, X. Which patients with hydrosalpinx will benefit more from reproductive surgery to improve natural pregnancy outcomes?: A systematic review and meta-analysis. Medicine.2023; 102(8).
- Pérez‐Milán, F., Caballero‐Campo, M., Carrera‐Roig, M., Moratalla‐Bartolomé, E., Domínguez‐Arroyo, J. A., Alcázar‐Zambrano, J. L., ... & Carugno, J. A. Systematic review and network meta‐analysis of hydrosalpinx treatment before in vitro fertilization.Ultrasound in Obstetrics & Gynecology.2024;5.
- Atlıhan U, Deründere Ü. Results Of Spontaneous Pregnancy After Hysterosalpingography İn Patients With Unexplained Infertility. Journal of Pharmaceutical Negative Results. 2022;13(5):1847-1852.
- Yang, J. J., & Chapman, M. What are the risks associated with lipiodol hysterosalpingography? A literature review. Radiography. 2023;29(6):1041-1045.
- Wang Q, Sun Y, Fan R, Wang M, Ren C, Jiang A, Yang T. Role of inflammatory factors in the etiology and treatment of recurrent implantation failure.Reproductive Biology. 2022;22(4).
- Qiu X, Wang Q, Zhang Y, Zhao Q, Jiang Z, Zhou L. Prognostic Value of Neutrophils-to-Lymphocytes Ratio and Platelets-to-Lymphocytes Ratio in Sepsis Patients With Lymphopenia. Biomarker Insights. 2024;19(1).
- Djordjevic D, Rondovic G, Surbatovic M, Stanojevic I, Udovicic I, Andjelic T, et al. Neutrophil-to-lymphocyte ratio, monocyte-to lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume-to-platelet count ratio as biomarkers in critically ill and injured patients: which ratio to choose to predict outcome and nature of bacteremia? Mediators Inflamm. 2018;7(15).
- Diem S, Schmid S, Krapf M, Flatz L, Born D, Jochum W, et al. Neutrophil-to-lymphocyte ratio (nlr) and platelet-to-lymphocyte ratio (plr) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab. Lung Cancer. 2017;11(1):176-81.
- Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019;4(17).
- Handtke, S., & Thiele, T. Large and small platelets—(When) do they differ?. Journal of Thrombosis and Haemostasis. 2020;18(6):1256-1267.
- Repsold L, Joubert AM. Platelet Function, Role in Thrombosis, Inflammation, and Consequences in Chronic Myeloproliferative Disorders. Cells. 2021; 10(11):3034.
- Afsar N, Afroze IA, Tahniath H, Abid Z. Role of mean platelet volume as an adjunct in evaluation of acute inflammation. Annals of Pathology and Laboratory Medicine 2017;4(4):466-469
- M Nissen, V Sander, P Rogge, M Alrefai, R-B Tröbs. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio Might Predict Pediatric Ovarian Torsion: A Single-Institution Experience and Review of the Literature. Journal of Pediatric and Adolescent Gynecology.2021;34(3):334-340.
- Kang Q, Li W, Yu N, Fan L, Zhang Y, Sha M, et al. Predictive role of neutrophil-to-lymphocyte ratio in preeclampsia: A meta-analysis including 3982 patients. Pregnancy Hypertension.2020;20(4):111-118.
- Özer S, Yılmaz R, Sönmezgöz E, Karaaslan E, Taşkın S, Bütün İ, Demir O. Simple markers for subclinical inflammation in patients with Familial Mediterranean Fever. Med Sci Monit. 2015;21(1):298-303.
- Boyraz I, Koç B, Boyacı A, Tutoğlu A, Sarman H, Ozkan H. Ratio of neutrophil/lymphocyte and platelet/lympho cyte in patient with ankylosing spondylitis that are treating with anti-TNF. Int J Clin Exp Med 2014;7(9):2912-5
- Buonacera, A., Stancanelli, B., Colaci, M., & Malatino, L. Neutrophil to lymphocyte ratio: an emerging marker of the relationships between the immune system and diseases. International journal of molecular sciences.2022;23(7).
- Kolaczkowska E, Kubes P. Neutrophil recruitment and function in health and inflammation. Nat Rev Immunol 2013;13(3):159-75.
- Duan Y, Zhou Y, Peng Y, Shi X, Peng C. Inflammatory Markers in Women with Infertility: A Cross-Sectional Study. Inflammatory Markers in Women with Infertility: A Cross-Sectional Study. International Journal of General Medicine.2023;27(16):1113-1121.
- Tola EN. The association between in vitro fertilization outcome and the inflammatory markers of complete blood count among nonobese unexplained infertile couples. Taiwanese Journal of Obstetrics and Gynecology.2018;57(2):289-294.
- Yang H, Zhu L, Wang S, Lang J, Xu T. Noninvasive Diagnosis of Moderate to Severe Endometriosis: The Platelet-Lymphocyte Ratio Cannot Be a Neoadjuvant Biomarker for Serum Cancer Antigen 125. Journal of Minimally Invasive Gynecology. 2015;22(3):373-377.
- Avcioğlu SN, Altinkaya SÖ, Küçük M, Demircan-Sezer S, Yüksel H. Can Platelet Indices Be New Biomarkers for Severe Endometriosis? International Scholarly Research Notices.2014;26(3):
- Li L, Yu J, Zhou Z. Mean platelet volume and polycystic ovary syndrome: a systematic review and meta-analysis. Journal of International Medical Research. 2022;50(1).
- Al Subhi T, Al Jashnmi RN, Al Khaduri M, Gowri V. Prevalence of tubal obstruction in the hysterosalpingogram of women with primary and secondary infertility. J Reprod Infertil. 2013;14(4):214-216.
- Benksim A, Elkhoudri N, Addi RA, Baali A, Cherkaoui M. Difference between Primary and Secondary Infertility in Morocco: Frequencies and Associated Factors. Int J Fertil Steril. 2018;12(2):142-146.
- Abebe MS, Afework M, Abaynew Y. Primary and secondary infertility in Africa: systematic review with meta-analysis. Fertil Res Pract. 2020;6(1).
- Ambildhuke K, Pajai S, Chimegave A, Mundhada R, Kabra P. A Review of Tubal Factors Affecting Fertility and its Management. Cureus. 2022;14(11)
- Elsharif, A. K., Mohamed, M. E. S., Nossair, W. S., & Fattah, M. T. A.. Relationship between Female Infertility and Pelvic Inflammatory Disease. European Journal of Molecular and Clinical Medicine.2021; 8(4):1007-1015.
- Seçkin KD, Karslı MF, Yücel B, Özköse B, Yıldırım D, Çetin BA & Aslan H. Neutrophil lymphocyte ratio, platelet lymphocyte ratio and mean platelet volume; which one is more predictive in the diagnosis of pelvic inflammatory disease? Gynecology Obstetrics & Reproductive Medicine.2015;21(3):150-154.
- Guo C, Zhang C. Platelet-to-Lymphocyte Ratio and CA125 Level as a Combined Biomarker for Diagnosing Endometriosis and Predicting Pelvic Adhesion Severity. Front Oncol. 2022;21(12).
- M. Hocaoglu, A. Turgut, E. Akdeniz, A. Usta, A.A. Ersahin, A. Karateke. Predictive value of neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio and mean platelet volume for pelvic inflammatory disease. Clin. Exp. Obstet. Gynecol. 2019;46(1):36–41.
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | September 9, 2024 |
| Submission Date | March 29, 2024 |
| Acceptance Date | June 2, 2024 |
| Published in Issue | Year 2024Volume: 63 Issue: 3 |
