International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2024
The importance of blood-count-derived inflammatory markers in predicting methotrexate success in patients with tubal ectopic pregnancy.
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Dereli Murat Levent, Savran Üçok Belgin, Özkan Sadullah, Sucu Sadun, Topkara Serap, Fıratlıgil Fahri Burçin, Ercan Emel Ebru, Uğur Merve, Akdaş Reis Yıldız, Engin Üstün Yaprak
Аннотация
OBJECTIVE: To investigate the systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) in predicting a successful methotrexate response in tubal ectopic pregnancy (TEP).
METHODS: Women treated for TEP at a tertiary hospital between 2017 and 2021 were retrospectively reviewed. A total of 502 (100%) eligible patients who received methotrexate were included and divided into two groups based on whether or not they were successfully treated with methotrexate alone. Inflammatory parameters derived from the patients' hemograms at hospital admission were compared.
RESULTS: In total, 434 (86.4%) patients were successfully treated with methotrexate alone (Group 1), while 68 (13.6%) patients underwent surgery after methotrexate failure (Group 2). Median neutrophil count, NLR, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, SII, largest ectopic mass diameter, and β-human chorionic gonadotropin (β-hCG) were significantly lower, whereas median lymphocyte and platelet counts were significantly higher in Group 1. According to the receiver operating characteristic analysis performed for the discriminatory power of NLR, β-hCG, and SII for methotrexate response, the area under the curve values were 0.742, 0.730, and 0.699, respectively.
CONCLUSION: Low NLR and SII are associated with methotrexate success and could be used to refine decision making regarding β-hCG for predicting successful response to methotrexate in patients with TEP.
METHODS: Women treated for TEP at a tertiary hospital between 2017 and 2021 were retrospectively reviewed. A total of 502 (100%) eligible patients who received methotrexate were included and divided into two groups based on whether or not they were successfully treated with methotrexate alone. Inflammatory parameters derived from the patients' hemograms at hospital admission were compared.
RESULTS: In total, 434 (86.4%) patients were successfully treated with methotrexate alone (Group 1), while 68 (13.6%) patients underwent surgery after methotrexate failure (Group 2). Median neutrophil count, NLR, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, SII, largest ectopic mass diameter, and β-human chorionic gonadotropin (β-hCG) were significantly lower, whereas median lymphocyte and platelet counts were significantly higher in Group 1. According to the receiver operating characteristic analysis performed for the discriminatory power of NLR, β-hCG, and SII for methotrexate response, the area under the curve values were 0.742, 0.730, and 0.699, respectively.
CONCLUSION: Low NLR and SII are associated with methotrexate success and could be used to refine decision making regarding β-hCG for predicting successful response to methotrexate in patients with TEP.