Evaluation of Prognostic and Predictive Values of 
Hemogram Parameters in Patients with Advanced Stage 
Ovarian Carcinoma

OBJECTIVE The aim of the present study was to evaluate the impact of conventional hemogram parameters as a biomarker in epithelial ovarian cancer (EOC) patients; and the clinical importance of the difference after chemotherapy. METHODS We have evaluated the patients with advanced-stage EOC who diagnosed between January 2012 and December 2017. RESULTS Elevated levels of neutrophils, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio at the time of diagnosis were significantly associated with excess amount of ascites. Lower levels of neutrophils and hemoglobin (HGB); and higher levels of red cell distribution width (RDW), and RDW/HGB ratio were predictors of platinum-sensitivity. In univariate analysis, while decreased mean platelet volume (MPV) was associated with longer disease free survival (DFS); elevated RDW, decreased neutrophils, MPV, and NLR were effective for better overall survival (OS). In multivariate analysis, platinum sensitivity and MPV were significantly associated with DFS and OS. Importantly, patients with persistently low MPV group after chemotherapy had the best OS; while persistently high MPV group had the worst OS. CONCLUSION MPV is a marker that can be easily evaluated during complete blood counts, and might be a promising and practical prognostic biomarker in the field of EOC. Hemogram parameters are found useful to predict disease properties and survival in EOC.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Torre LA, Siegel RL, Ward EM, Jemal A. Global cancer incidence and mortality rates and trends--an update. Cancer Epidemiol Biomarkers Prev 2016;25(1):16–27.
2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015;65(1):5–29.
3. Wright AA, Bohlke K, Armstrong DK, Bookman MA, Cliby WA, Coleman RL, et al. Neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer: Society of gynecologic oncology and american society of clinical oncology clinical practice guideline. Gynecol Oncol 2016;143(1):3–15.
4. Bhalla A, Zulfiqar M, Bluth MH. Molecular diagnostics in colorectal carcinoma: Advances and applications for 2018. Clin Lab Med 2018;38(2):311–42.
5. Itzkowitz SH, Yio X. Inflammation and cancer IV. Colorectal cancer in inflammatory bowel disease: the role of inflammation. Am J Physiol Gastrointest Liver Physiol 2004;287(1):G7–17.
6. Elinav E, Nowarski R, Thaiss CA, Hu B, Jin C, Flavell RA. Inflammation-induced cancer: Crosstalk between tumours, immune cells and microorganisms. Nat Rev Cancer 2013;13(11):759–71.
7. Lalosevic J, Gajic-Veljic M, Bonaci-Nikolic B, Stojkovic Lalosevic M, Nikolic M. Combined intravenous pulse and topical corticosteroid therapy for severe alopecia areata in children: Comparison of two regimens. Dermatol Ther. 2019;32(6):e13092.
8. Li JY, Li Y, Jiang Z, Wang RT, Wang XS. Elevated mean platelet volume is associated with presence of colon cancer. Asian Pac J Cancer Prev 2014;15(23):10501–4.
9. Kemal Y, Demirag G, Ekiz K, Yucel I. Mean platelet volume could be a useful biomarker for monitoring epithelial ovarian cancer. J Obstet Gynaecol 2014;34(6):515–8.
10.Sahin ZA, Toktas IU, Toraman C, Yuksel IT, Seyhan A, Akbayir O. Clinical and prognostic value of pre-operative systemic inflammatory markers in clinical course and prognosis of ovarian cancer. Eur J Gynaecol Oncol 2020;41(6):924–30.
11.Soonthornthum T, Suraseraneewong V, Kengsakol K, Wijaithum K, Kasemsan P, Prommatt S. Thrombocytosis in advanced epithelial ovarian cancer. J Med Assoc Thai 2007;90(8):1495–500.
12.Canzler U, Lück HJ, Neuser P, Sehouli J, Burges A, Harter P, et al. Prognostic role of thrombocytosis in recurrent ovarian cancer: A pooled analysis of the AGO study group. Arch Gynecol Obstet 2020;301(5):1267– 74.
13.Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, et al. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother 2009;58(1):15–23.
14.Yang Z, Gu JH, Guo CS, Li XH, Yang WC. Preoperative neutrophil-to-lymphocyte ratio is a predictor of survival of epithelial ovarian cancer: A systematic review and meta-analysis of observational studies. Oncotarget 2017;8(28):46414–24.
15.Qin YY, Wu YY, Xian XY, Qin JQ, Lai ZF, Liao L, et al. Single and combined use of red cell distribution width, mean platelet volume, and cancer antigen 125 for differential diagnosis of ovarian cancer and benign ovarian tumors. J Ovarian Res 2018;11(1):10.
16.Allensworth SK, Langstraat CL, Martin JR, Lemens MA, McGree ME, Weaver AL, et al. Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer. Gynecol Oncol 2013;130(3):499–504.
17.Yang W, Chen YY, Bi C, Shu KY, Ye ML, Li FF, et al. Predictive and prognostic values of preoperative platelet parameters in patients with gynecological tumors. J Clin Lab Anal 2020;34(7):e23295.
18.Li N, Yu Z, Zhang X, Liu T, Sun YX, Wang RT, et al. Elevated mean platelet volume predicts poor prognosis in colorectal cancer. Sci Rep 2017;7(1):10261.
19.Lian L, Xia YY, Zhou C, Shen XM, Li XL, Han SG, et al. Mean platelet volume predicts chemotherapy response and prognosis in patients with unresectable gastric cancer. Oncol Lett 2015;10(6):3419–24.
20.Gu M, Zhai Z, Huang L, Zheng W, Zhou Y, Zhu R, et al. Pre-treatment mean platelet volume associates with worse clinicopathologic features and prognosis of patients with invasive breast cancer. Breast Cancer 2016;23(5):752–60.
21.Chen H, Wu Q, Zhang Y, Li Q, Ma J, Kong F, et al. Nomograms based on the novel platelet index score predict postoperative prognosis in endometrial cancer. Gynecol Oncol 2020;158(3):689–97.
22.Sun L, Wei Y, Chen Y, Hu W, Ji X, Xu H, et al. Comparison of the prognostic value of platelet-related indices in biliary tract cancer undergoing surgical resection. Cancer Res Treat 2021;53(2):528–40.
23.Kumagai S, Tokuno J, Ueda Y, Marumo S, Shoji T, Nishimura T, et al. Prognostic significance of preoperative mean platelet volume in resected non-small-cell lung cancer. Mol Clin Oncol 2015;3(1):197–201.
24.Wang X, Cui MM, Xu Y, Liu L, Niu Y, Liu T, et al. Decreased mean platelet volume predicts poor prognosis in invasive bladder cancer. Oncotarget 2017;8(40):68115–22.
25.Yun ZY, Zhang X, Liu YS, Liu T, Liu ZP, Wang RT, et al. Lower mean platelet volume predicts poor prognosis in renal cell carcinoma. Sci Rep 2017;7(1):6700.
26.Yagyu T, Saito H, Sakamoto T, Uchinaka E, Morimoto M, Hanaki T, et al. Decreased mean platelet volume predicts poor prognosis in patients with pancreatic cancer. BMC Surg 2021;21(1):8.
27.Chen X, Li J, Zhang X, Liu Y, Wu J, Li Y, et al. Prognostic and clinicopathological significance of pretreatment mean platelet volume in cancer: A meta-analysis. BMJ Open 2020;10(10):e037614.
28.Pyo JS, Sohn JH, Kang G. Diagnostic and prognostic roles of the mean platelet volume in malignant tumors: A systematic review and meta-analysis. Platelets 2016;27(8):722–8.
29.Jeerakornpassawat D, Suprasert P. Potential predictors for chemotherapeutic response and prognosis in epithelial ovarian, fallopian tube and primary peritoneal cancer patients treated with platinum-based chemotherapy. Obstet Gynecol Sci 2020;63(1):55–63.
30.Kim HS, Choi HY, Lee M, Suh DH, Kim K, No JH, et al. Systemic inflammatory response markers and CA125 levels in ovarian clear cell carcinoma: A two center cohort study. Cancer Res Treat 2016;48(1):250–8.

APA	Ak N, Paksoy N, Ferhatoglu F, Aydın E, Dogan I, Bektaş E, Karaca M, oguz soydinc h, MİNARECİ Y, sözen h, Topuz S, Saip P, VATANSEVER S (2021). Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. , 438 - 445. 10.5505/tjo.2021.2882
Chicago	Ak Naziye,Paksoy Nail,Ferhatoglu Ferhat,Aydın Esra,Dogan Izzet,Bektaş Erdem,Karaca Mert,oguz soydinc hilal,MİNARECİ Yağmur,sözen hamdullah,Topuz Samet,Saip Pınar,VATANSEVER SEZAI Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. (2021): 438 - 445. 10.5505/tjo.2021.2882
MLA	Ak Naziye,Paksoy Nail,Ferhatoglu Ferhat,Aydın Esra,Dogan Izzet,Bektaş Erdem,Karaca Mert,oguz soydinc hilal,MİNARECİ Yağmur,sözen hamdullah,Topuz Samet,Saip Pınar,VATANSEVER SEZAI Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. , 2021, ss.438 - 445. 10.5505/tjo.2021.2882
AMA	Ak N,Paksoy N,Ferhatoglu F,Aydın E,Dogan I,Bektaş E,Karaca M,oguz soydinc h,MİNARECİ Y,sözen h,Topuz S,Saip P,VATANSEVER S Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. . 2021; 438 - 445. 10.5505/tjo.2021.2882
Vancouver	Ak N,Paksoy N,Ferhatoglu F,Aydın E,Dogan I,Bektaş E,Karaca M,oguz soydinc h,MİNARECİ Y,sözen h,Topuz S,Saip P,VATANSEVER S Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. . 2021; 438 - 445. 10.5505/tjo.2021.2882
IEEE	Ak N,Paksoy N,Ferhatoglu F,Aydın E,Dogan I,Bektaş E,Karaca M,oguz soydinc h,MİNARECİ Y,sözen h,Topuz S,Saip P,VATANSEVER S "Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma." , ss.438 - 445, 2021. 10.5505/tjo.2021.2882
ISNAD	Ak, Naziye vd. "Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma". (2021), 438-445. https://doi.org/10.5505/tjo.2021.2882

APA	Ak N, Paksoy N, Ferhatoglu F, Aydın E, Dogan I, Bektaş E, Karaca M, oguz soydinc h, MİNARECİ Y, sözen h, Topuz S, Saip P, VATANSEVER S (2021). Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. Türk Onkoloji Dergisi, 36(4), 438 - 445. 10.5505/tjo.2021.2882
Chicago	Ak Naziye,Paksoy Nail,Ferhatoglu Ferhat,Aydın Esra,Dogan Izzet,Bektaş Erdem,Karaca Mert,oguz soydinc hilal,MİNARECİ Yağmur,sözen hamdullah,Topuz Samet,Saip Pınar,VATANSEVER SEZAI Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. Türk Onkoloji Dergisi 36, no.4 (2021): 438 - 445. 10.5505/tjo.2021.2882
MLA	Ak Naziye,Paksoy Nail,Ferhatoglu Ferhat,Aydın Esra,Dogan Izzet,Bektaş Erdem,Karaca Mert,oguz soydinc hilal,MİNARECİ Yağmur,sözen hamdullah,Topuz Samet,Saip Pınar,VATANSEVER SEZAI Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. Türk Onkoloji Dergisi, vol.36, no.4, 2021, ss.438 - 445. 10.5505/tjo.2021.2882
AMA	Ak N,Paksoy N,Ferhatoglu F,Aydın E,Dogan I,Bektaş E,Karaca M,oguz soydinc h,MİNARECİ Y,sözen h,Topuz S,Saip P,VATANSEVER S Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. Türk Onkoloji Dergisi. 2021; 36(4): 438 - 445. 10.5505/tjo.2021.2882
Vancouver	Ak N,Paksoy N,Ferhatoglu F,Aydın E,Dogan I,Bektaş E,Karaca M,oguz soydinc h,MİNARECİ Y,sözen h,Topuz S,Saip P,VATANSEVER S Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma. Türk Onkoloji Dergisi. 2021; 36(4): 438 - 445. 10.5505/tjo.2021.2882
IEEE	Ak N,Paksoy N,Ferhatoglu F,Aydın E,Dogan I,Bektaş E,Karaca M,oguz soydinc h,MİNARECİ Y,sözen h,Topuz S,Saip P,VATANSEVER S "Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma." Türk Onkoloji Dergisi, 36, ss.438 - 445, 2021. 10.5505/tjo.2021.2882
ISNAD	Ak, Naziye vd. "Evaluation of Prognostic and Predictive Values of Hemogram Parameters in Patients with Advanced Stage Ovarian Carcinoma". Türk Onkoloji Dergisi 36/4 (2021), 438-445. https://doi.org/10.5505/tjo.2021.2882