Could the Platelet-to-Lymphocyte Ratio be a Novel Marker for Predicting Invasiveness of Cervical Pathologies?

  • Kose, Mesut (Department of Obstetrics and Gynecology, Faculty of Medicine, Afyonkarahisar Kocatepe University) ;
  • Celik, Fatih (Department of Obstetrics and Gynecology, Faculty of Medicine, Afyonkarahisar Kocatepe University) ;
  • Kose, Seda Kayman (Department of Obstetrics and Gynecology, Faculty of Medicine, Afyonkarahisar Kocatepe University) ;
  • Arioz, Dagistan Tolga (Department of Obstetrics and Gynecology, Faculty of Medicine, Afyonkarahisar Kocatepe University) ;
  • Yilmazer, Mehmet (Department of Obstetrics and Gynecology, Faculty of Medicine, Afyonkarahisar Kocatepe University)
  • Published : 2015.03.04


Purpose: To determine whether the preoperative platelet to lymphocyte ratio (PLR) could predict invasiveness of cervical pathologies. Materials and Methods: Patients with preinvasive and invasive diseases were reviewed retrospectively, over a nine-year period, 2005-2014. The pathological records and completed blood counts of the patients were collected and recorded in the SPSS program. Patients were divided in two groups, preinvasive and invasive. Results: The median PLR was significantly higher in the invasive group than in the preinvasive group (p=0.03). There was a correlation between invasion of cervical cancer and white blood cell count, red cell distributing width (RDW), neutrophil-lymphocyte ratio (NLR), and PLR. Conclusions: This study showed that patients with uterine cervical cancer may present with leukocytosis, increased RDW, NLR and PLR. These cheap and easily available parameters, especially PLR, may provide useful information about the invasiveness of cervical lesions.


  1. Acmaz G, Aksoy H, Unal D, et al (2014). Are neutrophil/ lymphocyte and platelet/lymphocyte ratios associated with endometrial precancerous and cancerous lesions in patients with abnormal uterine bleeding? Asian Pac J Cancer Prev, 15, 1689-92.
  2. Alexandrakis MG, Passam FH, Moschandrea IA, et al (2003). Levels of serum cytokines and acute phase proteins in patients with essential and cancer-related thrombocytosis. Am J Clin Oncol, 26, 135-40.
  3. Babu SN, Chetal G, Kumar S (2012). Macrophage migration inhibitory factor: a potential marker for cancer diagnosis and therapy. Asian Pac J Cancer Prev, 13, 1737-44.
  4. Bessman JD (1985). More on the RDW. Am J Clin Pathology, 84, 773.
  5. Bucak A, Ulu S, Oruc S, et al (2013). Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of bell palsy. Laryngoscope, 124, 1678-81.
  6. Klinger, MH, Jelkmann W (2002). Role of blood platelets in infection and inflammation. J Interferon Cytokine Res, 22, 913-22.
  7. Koss LG, Stewart F, Foote FW, et al (1963). Some histological aspects of behavior of epidermoid carcinoma in situ and related lesions of the uterine cervix. a long-term prospective study. Cancer, 16, 1160-211.<1160::AID-CNCR2820160910>3.0.CO;2-4
  8. Lee WS, Kim TY (2010). Relation between red blood cell distribution width and inflammatory biomarkers in rheumatoid arthritis. Arch Pathol Lab Med, 134, 505-6.
  9. Ozturk Z A, Unal A, Yigiter R, et al (2013). Is increased red cell distribution width (RDW) indicating the inflammation in Alzheimer's disease (AD)? Arch Gerontol Geriatr, 56, 50-4.
  10. Pund ER, Nieburgs HE (1947). Preinvasive carcinoma of the cervix uteri: seven cases in which it was detected by examination of rutine endocervical smears. Arch Pathol Lab Med, 44, 571-7.
  11. Richart RM, Sciarra JJ (1968). Treatment of cervical dysplasia by outpatient electrocauterization. Am J Obstet Gynecol, 101, 200-5.
  12. Rudiger A, Burckhardt OA, Harpes P, Muller SA, Follath F (2006). The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med, 24, 451-4.
  13. Schmidt MI, Duncan BB, Sharrett AR, (1999). Markers of inflammation and prediction of diabete mellitus in adults:a cohort study. Lancet, 353, 1649-52.
  14. Siegel R, Naishadham D, Jemal A (2013). Cancer statistics, 2013. CA Cancer J Clin, 63, 11-30.
  15. Smith RA, Bosonnet L, Ghaneh P, et al (2008). The plateletlymphocyte ratio improves the the predictive value of serum CA 19.9 levels in determining patient selection for staging laparascopy in suspected periampullary cancer. Surgery, 143, 658-66.
  16. Spell DW, Jones DV, Jr, Harper WF, David Bessman J (2004). The value of a complete blood count in predicting cancer of the colon. Cancer Detect Prev, 28, 37-42.
  17. Sprague BL, Trentham-Dietz A, Klein BE, et al (2008). Physical activity, white blood cell count, and lung cancer risk in a prospective cohort study. Cancer Epidemiol Biomarkers Prev, 17, 2714-22.
  18. Tavares-Murta BM, Mendonca MA, Duarte NL, et al (2010). Systemic leukocyte alterations are associated with invasive uterine cervical cancer. Int J Gynecol Cancer, 20, 1154-9.
  19. Ulu S, Bucak A, Ulu MS, et al (2013). Neutrophil-lymphocyte ratio as a new predictive and prognostic factor at the hearing loss of diabetic patients. Eur Arch Otorhinolaryngol, 271, 2681-6.
  20. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ (2005). Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol, 91, 181-4.
  21. Yesil A, Senates E, Bayoglu IV, et al (2011). Red cell distribution width: A novel marker of activity in inflammatory bowel disease. Gut Liver, 5, 460-7.

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