New Inflammation Markers for Distinguishing Uterine Adenomyosis and Leiomyoma
Condition: Adenomyosis; Leiomyoma; Inflammation
MeSH terms: Leiomyoma; Myofibroma; Adenomyosis; Inflammation
Study type: Observational

Summary: 
      Both pelvic masses and preoperative diagnosis of them have still continued as an important
      investigation subject. It is important to discriminate the diagnoses of leiomyoma and
      adenomyosis before operation especially among infertile patients. Neoplasms can alter
      systemic or local immune response in their originating area.Neutrophil to lymphocyte ratio
      (NLR) and platelet to lymphocyte ratio (PLR) can be readily determined by using of complete
      blood counter test (CBC). A high NLR has been shown in systemic inflammation, some
      gynecologic and gastrointestinal cancers and some cardiovascular diseases.

      The investigators aim to investigate using new inflammation markers, NLR and PLR, whether
      they are useful to discriminate between adenomyosis and leiomyoma. As far as is known, there
      have been no previous reports about the association among NLR, PLR, adenomyosis and
      leiomyoma.
    

Detailed description: 
      A retrospective cross-sectional study was conducted at the Kayseri Education and Research
      Hospital, Department of Obstetrics and Gynecology, Kayseri, Turkey, between January 2016 and
      October 2016.

      Approval of the Institutional Review Board of Kayseri Erciyes University the Faculty of
      Medicine was obtained in advance (2016/525).

      Exclusion criteria were as fallows; diabetes mellitus, metabolic disorder, acute or chronic
      infection disease, hypertension, acute coroner artery disease, connective tissue disorder,
      vasculitis, inflammatory bowel disease, tobacco and alcohol use, renal failure, hepatitis,
      patients using corticosteroid drug and patients underwent blood transfusion within three
      months. The investigators reviewed a database of 386 patients who were referred for abnormal
      uterine bleeding resistant to medical treatment or detected pelvic mass in postmenopausal and
      premenopausal period and underwent hysterectomy in our department. The investigators are
      capable of including 196 patients in the present study because of exclusion criteria.

      There were three groups in our study. First group called adenomyosis was consisted of
      patients who were pathologically diagnosed pure adenomyosis after hysterectomy. Second group
      called leiomyoma was consisted of patients who were pathologically diagnosed pure leiomyoma
      after hysterectomy. Third group called control group was consisted of healthy patients who
      were pathologically diagnosed no neoplasm after hysterectomy.

      In order to evaluate serum levels of hemoglobin, leukocytes, neutrophil, lymphocyte, platelet
      and CA125, the investigators obtained data analysis measured preoperatively from venous blood
      samples of all subjects. The NLR was defined as the absolute neutrophil count divided by the
      absolute lymphocyte count and the PLR was defined as the absolute platelet count divided by
      the absolute lymphocyte count.
    

Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        There were three groups in our study. First group called adenomyosis was consisted of
        patients who were pathologically diagnosed pure adenomyosis after hysterectomy. Second
        group called leiomyoma was consisted of patients who were pathologically diagnosed pure
        leiomyoma after hysterectomy. Third group called control group was consisted of healthy
        patients who were pathologically diagnosed no neoplasm after hysterectomy.
      
Keywords: adenomyosis; leiomyoma; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio