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Comparative Study
. 2025 Jul 5;25(1):333.
doi: 10.1186/s12905-025-03890-1.

The comparison of hematological inflammatory parameters before and after surgery in women with endometriosis: retrospective cohort study

Onur Yavuz  1 , Asli Akdoner  2 , Kadir Alper Mankan  2 , Ufuk Atlihan  3 , Begum Ertan  4 , Mehmet Guney  2
Affiliations
Comparative Study

The comparison of hematological inflammatory parameters before and after surgery in women with endometriosis: retrospective cohort study

Onur Yavuz et al. BMC Womens Health. .

Abstract

Background: Our aim was to compare preoperative and postoperative hematological inflammatory parameters in women with endometriosis.

Methods: Data were collected from 411 patients who underwent laparoscopy surgery between January 2018 and December 2023. Postoperatively, the pathology reports indicated ovarian endometrioma in 201 patients (48.9%) and other benign ovarian cysts in 210 patients (51.1%). Subgroups were categorized as stage 1-2 endometriosis (n = 26, 6.3%), stage 3-4 endometriosis (n = 175, 42.6%) and benign ovarian cysts (n = 210, 51.1%). Hematological inflammatory markers and ultrasound findings were evaluated one week before the operation and six weeks after the operation and compared between groups. Statistical analysis was performed by SPSS version 26.0 Not normally distributed parameters were analyzed with the Kruskal Wallis, post hoc and Mann-Whitney U tests. Wilcoxon signed-rank test was used to determine changes before and after treatment. Chi-square test and Fisher precision test were used in the analysis of categorical data. Receiver operating characteristic analysis was performed to calculate the area under the curve, which indicates the average sensitivity of variables and its 95% confidence interval are reported for each assessed parameter. The appropriate cut-off value indicating the sum of the highest sensitivity and specificity was calculated for the most predictive variable. The p value considered statistically significant was < 0.05.

Results: When comparing the postoperative and preoperative parameters of the main groups, it was determined that the NLR, MLR, and PLR values of both groups increased in the postoperative period, whereas the CA-125 value decreased. In a similar comparison within the subgroups, it was determined that NLR and PLR increased in all three groups in the postoperative period. MLR was found to increase in the stage 3-4 endometriosis and benign ovarian cyst groups. CA-125 decreased in the stage 3-4 endometriosis and benign ovarian cyst groups. RDW > 13.5, PLR > 123.4 and CA-125 > 35 were determined as the cut-off value to predict endometriosis.

Conclusion: During the follow-ups, we revealed that CA-125 still maintains its effectiveness. There is a lack of existing literature that directly compares hematological inflammatory parameters before and after treatment for endometriosis.

Keywords: CA-125; Endometriosis; Neutrophil to lymphocyte ratio; Platelet to lymphocyte ratio.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in line with the principles of the Declaration of Helsinki. And this was a retrospectivexcohort research. All procedures performed were in accordance with the ethical standarts of the institutional committee (Name: Dokuz Eylul University Ethics Committee, File Number: 8659-GOA, Date: 2024/04–16). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Receiver operating characteristic curves of preoperative variables in diagnosing endometriosis
Fig. 2
Fig. 2
STARD diagram to report participants’ flow by preoperative variables throughout the study
See this image and copyright information in PMC

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