Neutrophil to Lymphocyte Ratio As an Assessment Tool to Differentiate Between Uterine Sarcoma and Myoma: A Systematic Review and Meta-Analysis Publisher Pubmed



Tabatabaei F^{1, 2} ; Babadi S³ ; Nourigheimasi S⁴ ; Ghaedi A^{5, 6} ; Khanzadeh M⁷ ; Bazrgar A⁵ ; Gargari MK⁸ ; Khanzadeh S⁸
Source: BMC Cancer Published:2024

Abstract

Background: This systematic review and meta-analysis aimed to determine the potential value of neutrophil to lymphocyte ratio (NLR) as an assessment tool in the clinical distinction between uterine sarcoma and uterine leiomyoma. Methods: We comprehensively searched Web of Science, Scopus, and PubMed for relevant papers published before March 19, 2023. The standardized mean difference (SMD) was provided, along with a 95% confidence interval (CI). The random-effects model was employed to derive pooled effects due to the high levels of heterogeneity. The Newcastle-Ottawa scale was used for the quality assessment. Our study was registered in PROSPERO (CRD42023478331). Results: Overall, seven articles were included in the analysis. A random-effect model revealed that patients with uterine sarcoma had higher NLR levels compared to those with uterine myoma (SMD = 0.60, 95% CI = 0.22–0.98; p = 0.002). In the subgroup analysis according to sample size, we found that patients with uterine sarcoma had elevated levels of NLR compared to those with uterine myoma in either large studies (SMD = 0.58, 95% CI = 0.04–1.13; P < 0.001) or small studies (SMD = 0.64, 95% CI = 0.33–0.96; P = 0.32). In the sensitivity analysis, we found that the final result was not significantly changed when single studies were removed, suggesting that the finding of this meta-analysis was stable. The pooled sensitivity of NLR was 0.68 (95% CI = 0.61–0.73), and the pooled specificity was 0.64 (95% CI = 0.59–0.69). Conclusion: NLR might be utilized as an assessment tool in clinics to help clinicians differentiate between patients with uterine sarcoma and those with myoma. © 2023, The Author(s).