Awassada Punyashthira

Study on Preoperative Neutrophil/Lymphocyte (NLR) and Platelet/Lymphocyte Ratio (PLR) as a Predictive Factor in Endometrial Cancer

To evaluate predictive factors between serum inflammatory markers and malignancy potential of endometrium. This retrospective study was conducted at the gynecological oncology unit, department of obstetrics and gynecology, at the faculty of medicine of Thammasat University. The study period was from 2017 to 2020. Endometrial cancer and benign gynecologic disease cases who underwent hysterectomy (with or without adnexectomy) during the study period were recruited. Demographic characteristics, histopathology reports and serum markers were also collected. The study included a study group of 49 participants with endometrial cancer and a control group consisting of 119 cases of benign uterine disease. The study group had statistically significantly higher mean ages, proportional menopausal status and instances of underlying diseases when compared with the control group. Neutrophil/Lymphocyte ratios (NLR) and Platelet/Lymphocyte ratios (PLR) could not meaningfully predict the malignant potential of endometrium in hysterectomy specimens. NLR and PLR were statistically associated with depth of myometrial invasion (MI) in endometrial cancer cases. NLR equal to or greater than 1.93 predicted MI more than half thickness with sensitivity, specificity, accuracy, positive (PPV) and negative predictive value (NPV) at a percentage of 83.3, 52.8, 37.0, 90.5 and 60.4, respectively. PLR equal to or greater than 134.95 predicted MI of greater than fifty percent thickness with sensitivity, specificity, accuracy, PPV and NPV at 75.0, 55.6, 36.0, 87.0 and 60.4 percent, respectively. NLR and PLR have positive associations with myometrial invasion of endometrial cancer.

Prediction Score of Cervical Intraepithelial Neoplasia Grade II or Higher (CIN2+) in Patients with Low-Grade Cytology (ASC-US, LSIL) and HPV- Negative or Non-type 16/18 High-Risk HPV-Positive Results

The aim of this study was to identify and quantify the risk factors with the greatest impact on the development of CIN2+ in patients with low-grade cytology and either HPV-negative or high-risk HPV-positive (non-16/18) results. The secondary aim was to develop and validate a multiparameter, risk-based prediction system. This retrospective cohort study was conducted in the Department of Obstetrics and Gynecology at Thammasat University Hospital between January 2021 and December 2024. Women who underwent cervical cancer screening and had a report of low-grade cytological abnormalities (ASC-US or LSIL), with either non-16/18 high-risk HPV infection or a negative HPV test, were included. A total of 480 participants were included. The mean age of participants was 40.7 years. The prevalence of CIN2+ was 15.6% (75/480). The predictive model was developed by incorporating six factors: having three or more deliveries, six or more lifetime sexual partners, smoking, no cervical screening within five years, lack of HPV vaccination, and high-risk HPV positivity (non-16/18). Subjects with a score of 5 or more out of 14 points were classified as high-risk and recommended to undergo colposcopy within four weeks. The model demonstrated a sensitivity of 97.3% and a negative predictive value (NPV) of 98.6%. The risk factors for CIN2+ included having three or more deliveries, six or more lifetime sexual partners, smoking, no cervical screening within the past five years, lack of HPV vaccination, and high-risk HPV positivity (non-16/18). The predictive model demonstrated a sensitivity of 97.3% and a negative predictive value (NPV) of 98.6%.