Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1371/journal.pone.0277892 http://hdl.handle.net/11449/247975 |
Resumo: | OBJECTIVE: To relate preevacuation platelet count and leukogram findings, especially neutrophil/lymphocyte ratios (NLR) and platelet/lymphocyte ratios with the occurrence of gestational trophoblastic neoplasia (GTN) after complete hydatidiform mole (CHM) among Brazilian women. METHODS: Retrospective cohort study of patients with CHM followed at Rio de Janeiro Federal University, from January/2015-December/2020. Before molar evacuation, all patients underwent a medical evaluation, complete blood count and hCG measurement, in addition to other routine preoperative tests. The primary outcome was the occurrence of postmolar GTN. RESULTS: From 827 cases of CHM treated initially at the Reference Center, 696 (84.15%) had spontaneous remission and 131 (15.85%) developed postmolar GTN. Using optimal cut-offs from receiver operating characteristic curves and multivariable logistic regression adjusted for the possible confounding variables of age and preevacuation hCG level (already known to be associated with the development of GTN) we found that ≥2 medical complications at presentation (aOR: 1.96, CI 95%: 1.29-2.98, p<0.001) and preevacuation hCG ≥100,000 IU/L (aOR: 2.16, CI 95%: 1.32-3.52, p<0.001) were significantly associated with postmolar GTN after CHM. However, no blood count profile findings were able to predict progression from CHM to GTN. CONCLUSION: Although blood count is a widely available test, being a low-cost test and mandatory before molar evacuation, and prognostic for outcome in other neoplasms, its findings were not able to predict the occurrence of GTN after CHM. In contrast, the occurrence of medical complications at presentation and higher preevacuation hCG levels were significantly associated with postmolar GTN and may be useful to guide individualized clinical decisions in post-molar follow-up and treatment of these patients. |
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Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasiaOBJECTIVE: To relate preevacuation platelet count and leukogram findings, especially neutrophil/lymphocyte ratios (NLR) and platelet/lymphocyte ratios with the occurrence of gestational trophoblastic neoplasia (GTN) after complete hydatidiform mole (CHM) among Brazilian women. METHODS: Retrospective cohort study of patients with CHM followed at Rio de Janeiro Federal University, from January/2015-December/2020. Before molar evacuation, all patients underwent a medical evaluation, complete blood count and hCG measurement, in addition to other routine preoperative tests. The primary outcome was the occurrence of postmolar GTN. RESULTS: From 827 cases of CHM treated initially at the Reference Center, 696 (84.15%) had spontaneous remission and 131 (15.85%) developed postmolar GTN. Using optimal cut-offs from receiver operating characteristic curves and multivariable logistic regression adjusted for the possible confounding variables of age and preevacuation hCG level (already known to be associated with the development of GTN) we found that ≥2 medical complications at presentation (aOR: 1.96, CI 95%: 1.29-2.98, p<0.001) and preevacuation hCG ≥100,000 IU/L (aOR: 2.16, CI 95%: 1.32-3.52, p<0.001) were significantly associated with postmolar GTN after CHM. However, no blood count profile findings were able to predict progression from CHM to GTN. CONCLUSION: Although blood count is a widely available test, being a low-cost test and mandatory before molar evacuation, and prognostic for outcome in other neoplasms, its findings were not able to predict the occurrence of GTN after CHM. In contrast, the occurrence of medical complications at presentation and higher preevacuation hCG levels were significantly associated with postmolar GTN and may be useful to guide individualized clinical decisions in post-molar follow-up and treatment of these patients.Department of Obstetrics and Gynecology Postgraduate Program in Perinatal Health Faculty of Medicine Maternity School of Rio de Janeiro Federal UniversityDepartment of Maternal Child Health Postgraduate Program in Medical Sciences Faculty of Medicine of Fluminense Federal UniversityNational Academy of Medicine Young Leadership Physicians ProgramPostgraduate Program in Applied Health Sciences Vassouras UniversityDepartment of Gynecology and Obstetrics Botucatu Trophoblastic Disease Center of the Clinical Hospital of Botucatu Medical School São Paulo State University - UNESPHospital Moinhos de VentoDepartment of Obstetrics Gynecology and Reproductive Biology New England Trophoblastic Disease Center Division of Gynecologic Oncology Brigham and Women's Hospital Harvard Medical SchoolDepartment of Gynecology and Obstetrics Botucatu Trophoblastic Disease Center of the Clinical Hospital of Botucatu Medical School São Paulo State University - UNESPMaternity School of Rio de Janeiro Federal UniversityFaculty of Medicine of Fluminense Federal UniversityYoung Leadership Physicians ProgramVassouras UniversityUniversidade Estadual Paulista (UNESP)Hospital Moinhos de VentoHarvard Medical SchoolBraga, AntonioCanelas, Ana ClaraTorres, BereniceMaesta, Izildinha [UNESP]Giongo Pedrotti, LuanaBessel, MarinaVieira Dos Santos Esteves, Ana PaulaAmim Junior, JoffreRezende Filho, JorgeElias, Kevin M.Horowitz, Neil S.Berkowitz, Ross S.2023-07-29T13:31:02Z2023-07-29T13:31:02Z2022-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlee0277892http://dx.doi.org/10.1371/journal.pone.0277892PloS one, v. 17, n. 12, p. e0277892-, 2022.1932-6203http://hdl.handle.net/11449/24797510.1371/journal.pone.02778922-s2.0-85143200909Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengPloS oneinfo:eu-repo/semantics/openAccess2023-07-29T13:31:02Zoai:repositorio.unesp.br:11449/247975Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462023-07-29T13:31:02Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia |
title |
Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia |
spellingShingle |
Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia Braga, Antonio |
title_short |
Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia |
title_full |
Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia |
title_fullStr |
Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia |
title_full_unstemmed |
Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia |
title_sort |
Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia |
author |
Braga, Antonio |
author_facet |
Braga, Antonio Canelas, Ana Clara Torres, Berenice Maesta, Izildinha [UNESP] Giongo Pedrotti, Luana Bessel, Marina Vieira Dos Santos Esteves, Ana Paula Amim Junior, Joffre Rezende Filho, Jorge Elias, Kevin M. Horowitz, Neil S. Berkowitz, Ross S. |
author_role |
author |
author2 |
Canelas, Ana Clara Torres, Berenice Maesta, Izildinha [UNESP] Giongo Pedrotti, Luana Bessel, Marina Vieira Dos Santos Esteves, Ana Paula Amim Junior, Joffre Rezende Filho, Jorge Elias, Kevin M. Horowitz, Neil S. Berkowitz, Ross S. |
author2_role |
author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Maternity School of Rio de Janeiro Federal University Faculty of Medicine of Fluminense Federal University Young Leadership Physicians Program Vassouras University Universidade Estadual Paulista (UNESP) Hospital Moinhos de Vento Harvard Medical School |
dc.contributor.author.fl_str_mv |
Braga, Antonio Canelas, Ana Clara Torres, Berenice Maesta, Izildinha [UNESP] Giongo Pedrotti, Luana Bessel, Marina Vieira Dos Santos Esteves, Ana Paula Amim Junior, Joffre Rezende Filho, Jorge Elias, Kevin M. Horowitz, Neil S. Berkowitz, Ross S. |
description |
OBJECTIVE: To relate preevacuation platelet count and leukogram findings, especially neutrophil/lymphocyte ratios (NLR) and platelet/lymphocyte ratios with the occurrence of gestational trophoblastic neoplasia (GTN) after complete hydatidiform mole (CHM) among Brazilian women. METHODS: Retrospective cohort study of patients with CHM followed at Rio de Janeiro Federal University, from January/2015-December/2020. Before molar evacuation, all patients underwent a medical evaluation, complete blood count and hCG measurement, in addition to other routine preoperative tests. The primary outcome was the occurrence of postmolar GTN. RESULTS: From 827 cases of CHM treated initially at the Reference Center, 696 (84.15%) had spontaneous remission and 131 (15.85%) developed postmolar GTN. Using optimal cut-offs from receiver operating characteristic curves and multivariable logistic regression adjusted for the possible confounding variables of age and preevacuation hCG level (already known to be associated with the development of GTN) we found that ≥2 medical complications at presentation (aOR: 1.96, CI 95%: 1.29-2.98, p<0.001) and preevacuation hCG ≥100,000 IU/L (aOR: 2.16, CI 95%: 1.32-3.52, p<0.001) were significantly associated with postmolar GTN after CHM. However, no blood count profile findings were able to predict progression from CHM to GTN. CONCLUSION: Although blood count is a widely available test, being a low-cost test and mandatory before molar evacuation, and prognostic for outcome in other neoplasms, its findings were not able to predict the occurrence of GTN after CHM. In contrast, the occurrence of medical complications at presentation and higher preevacuation hCG levels were significantly associated with postmolar GTN and may be useful to guide individualized clinical decisions in post-molar follow-up and treatment of these patients. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-01 2023-07-29T13:31:02Z 2023-07-29T13:31:02Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1371/journal.pone.0277892 PloS one, v. 17, n. 12, p. e0277892-, 2022. 1932-6203 http://hdl.handle.net/11449/247975 10.1371/journal.pone.0277892 2-s2.0-85143200909 |
url |
http://dx.doi.org/10.1371/journal.pone.0277892 http://hdl.handle.net/11449/247975 |
identifier_str_mv |
PloS one, v. 17, n. 12, p. e0277892-, 2022. 1932-6203 10.1371/journal.pone.0277892 2-s2.0-85143200909 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
PloS one |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
e0277892 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1792962383273000960 |