[Study on the predictive significance of PLR, SII and RPR in ovarian endometriotic cyst].

Objective: To investigate the predictive value of platelet-to-lymphocyte ratio (PLR), red blood cell distribution width to platelet count ratio (RPR) and systemic immune inflammation index (SII) in the staging and postoperative recurrence of ovarian endometrial cysts. Methods: Retrospective analysis was made on the clinical data of patients who underwent laparoscopic surgery for ovarian cysts in the Affiliated Hospital of Qingdao University from January 2018 to January 2020. The patients with ovarian endometriosis cyst confirmed by pathology after surgery were the observation group (n=350), and the patients with other benign ovarian cyst were the control group (n=150). The preoperative platelet count, platelet distribution width, absolute number of neutrophils, lymphocyte absolute number, absolute number of monocytes, red blood cell distribution width, and serum cancer antigen 125 (CA125) of the patients in two groups were recorded, and PLR, neutrophil-to-lymphocyte ratio (NLR), RPR, SII, and systemic inflammation response index (SIRI) were calculated and analyzed. The general data of all patients and the follow-up data within 2 years after the operation of the observation group were statistically recorded to evaluate the diagnostic value of PLR, RPR and SII for ovarian endometrial cyst, and the predictive value of staging and recurrence within 2 years after the operation. Results: PLR, NLR, SII (median: 147.53, 1.86, and 488.70 respectively) and CA125 (median: 59.41 kU/L) in the observation group were significantly higher than those in the control group, while RPR (median: 0.16) was lower than that in the control group, with significant differences (all P<0.01). There was no significant difference in SIRI between the two groups (P>0.05). The PLR and SII (median: 122.73, 345.00) of the observation group at stage Ⅲ and Ⅳ were higher than those of patients at stage Ⅰ and Ⅱ, and the RPR was lower than that of patients with stage Ⅰ and Ⅱ, with significant differences (all P<0.001). The PLR, NLR, SII, SIRI (median: 179.63, 2.75, 762.96, and 1.06 respectively) and CA125 (median: 108.83 kU/L) in patients with recurrence were significantly higher than those in patients without recurrence 2 years after the operation, and the differences were statistically significant (all P<0.001). The area under curve (AUC) of CA125 in the diagnosis of ovarian endometriosis cyst was 0.951, the sensitivity was 85.7%, and the specificity was 93.0%, which were higher than those of PLR and SII; the AUC of PLR+SII+CA125 in the diagnosis of ovarian endometriosis cyst was 0.952. The AUC of RPR predicting the stage of ovarian endometriosis cyst was 0.713, higher than PLR and SII, lower than CA125; the AUC of RPR+SII+CA125 in predicting the stage of ovarian endometriotic cyst was 0.825, with sensitivity of 68.7% and specificity of 85.7%. The AUC predicted by SII for recurrence of ovarian endometriotic cyst within 2 years after the operation was 0.803, higher than NLR, PLR, SIRI and CA125; the AUC of PLR+SII+CA125, sensitivity, specificity was 0.813, 81.5% and 73.0%, higher than SII. Conclusion: PLR, RPR and SII are related to the staging of ovarian endometriotic cyst, and SII has a certain predictive value for the recurrence of ovarian endometriotic cyst after surgery.目的： 探讨血小板与淋巴细胞比值（PLR）、红细胞分布宽度与血小板计数比值（RPR）及系统性免疫炎症指数（SII）对卵巢子宫内膜异位囊肿的分期及术后复发的预测价值。 方法： 回顾性分析2018年1月—2020年1月因卵巢囊肿于青岛大学附属医院行腹腔镜手术患者的临床资料，术后经病理检查证实为卵巢子宫内膜异位囊肿的患者为观察组（350例）、证实为卵巢其他良性肿瘤的患者为对照组（150例），记录2组患者术前的血小板计数、血小板分布宽度、中性粒细胞绝对数、淋巴细胞绝对数、单核细胞绝对数、红细胞分布宽度及血清癌相关抗原125（CA125），并计算PLR、中性粒细胞与淋巴细胞比值（NLR）、RPR、SII、系统性炎症反应指数（SIRI）并进行比较，记录所有患者的一般资料及观察组患者术后2年内的随访资料，评价PLR、RPR及SII对卵巢子宫内膜异位囊肿的诊断、分期的预测价值，对术后2年内复发的预测价值。 结果： 观察组患者的PLR、NLR、SII（中位数分别为147.53、1.86、488.70）及CA125（中位数为59.41 kU/L）显著高于对照组，RPR（中位数为0.16）低于对照组，分别比较，差异均有统计学意义（P均<0.01）；2组SIRI比较，差异无统计学意义（P>0.05）。观察组中，Ⅲ~Ⅳ期患者的PLR、SII（中位数分别为122.73、345.00）高于Ⅰ~Ⅱ期患者，RPR（中位数为0.18）低于Ⅰ~Ⅱ期患者，分别比较，差异均有统计学意义（P均<0.001）；术后2年复发患者的PLR、NLR、SII、SIRI（中位数分别为179.63、2.75、762.96、1.06）及CA125（中位数为108.83 kU/L）显著高于未复发患者，分别比较，差异均有统计学意义（P均<0.001）。CA125诊断卵巢子宫内膜异位囊肿的曲线下面积（AUC）为0.951，敏感度为85.7%，特异度为93.0%，均高于PLR和SII，PLR、SII、CA125三者联合诊断卵巢子宫内膜异位囊肿的AUC为0.952。RPR预测卵巢子宫内膜异位囊肿分期的AUC为0.713，高于PLR、SII，低于CA125；RPR、SII、CA125三者联合预测卵巢子宫内膜异位囊肿分期的AUC为0.825，敏感度为68.7%，特异度为85.7%，优于单个指标。SII预测卵巢子宫内膜异位囊肿术后2年内复发的AUC为0.803，高于NLR、PLR、SIRI及CA125；PLR、SII及CA125三者联合预测卵巢子宫内膜异位囊肿术后2年内复发的AUC为0.813，敏感度为81.5%，特异度为73.0%，高于SII。 结论： PLR、RPR、SII与卵巢子宫内膜异位囊肿的分期有关，SII对卵巢子宫内膜异位囊肿术后复发有一定的预测价值。.