Original Articles Preoperative Hematological Parameters for Predicting Ovarian Torsion in Patients with Mature Cystic Teratoma

Figures & data

Table 1 The Demographic Features and Hematological Parameters Between Torsion and Non-Torsion Groups

Characteristics	Torsion (N=37)	Non-Torsion (N=95)	p-value
Age (yrs.)	24.19 ± 14.9	19.9 ± 8.9	0.058
Size (cm)	8.2 ± 2.2	8.1 ± 3.9	0.123
WBC count (10^3/µL)	8.5 (5.4–15.5)	6.9 (3.1–16.5)	0.003^a
Hb (g/dL)	12.6 ± 1.0	12.9 ± 1.2	0.084
MCV (fl)	85.0 ± 4.8	86.0 ± 5.3	0.463
RDW (%)	12.4 (11.4–14.3)	12.6 (11.3–17.1)	0.529^a
PLT count (10^3/µL)	295.7 ± 64.2	292.4 ± 73.4	0.916
MPV (fl)	7.8 ± 0.8	7.8 ± 1.1	0.993
Neutrophil (%)	75.5 (40.6–92.0)	63.2 (32.5–94.9)	<0.001^a
Neutrophil count (10^3/µL)	6.70 (2.2–13.2)	4.37 (1.2–13.7)	0.002^a
Lymphocyte count (10^3/µL)	1.42 (0.6–3.5)	1.75 (0.5–32.4)	0.003^a
Monocyte count (10^3/µL)	0.25 (0.08–0.67)	0.33 (0.09–3.8)	0.026^a
NLR	4.33 (1.0–14.6)	2.33 (0.1–27.4)	<0.001^a
PLR	208 (88.1–418.5)	159 (4.8–821.7)	0.005^a
LMR	6.5 ± 3.9	8.5 ± 25.4	0.635
CA125 (U/mL)	23.7 ±15.3	25.4 ± 21.8	0.691
CA19-9 (U/mL)	141.9± 196.0	78.5 ± 168.2	0.229
AMH	4.0 ±3.4	6.2±3.6	0.122
Laterality
Right (%)	16 (43)	52 (55)	0.235^b
Left (%)	21 (57)	43 (45)	0.235^b
Operative method
Laparoscopy (%)	29 (78)	75 (79)	0.943^b
Laparotomy (%)	8 (22)	20 (21)	0.943^b
Type of operation
Cystectomy (%)	21 (57)	78 (82)	0.004^b
Oophorectomy (%)	16 (43)	17 (18)	0.004^b

Notes: Values are mean±standard deviation, median (Min-Max) or absolute numbers (percentage). ^aMann Whitney Test, ^bChi-square test.

Abbreviations: WBC, white blood cell; Hb, Hemoglobin; MCV, mean corpuscular volume; RDW, red cell distribution width; MPV, mean platelet; NLR, neutrophil to lymphocyte ratio; PLR, platelet to lymphocyte ratio; LMR, lymphocyte to monocyte ratio; CA 125, cancer antigen 125; CA 19–9, carbohydrate antigen; AMH, anti-müllerian hormone.

Table 2 The Demographic Features and Hematological Parameters Between Infarction and Non-Infarction Groups

Characteristics	Infarction (N=6)	Non-Infarction (N=31)	p-value
Age (yrs.)	19.5 (10–29)	25 (23–27)	0.565^a
Size (cm)	7 (7–7)	9.75 (9.5–10.0)	0.917^a
WBC count (10^3/µL)	11.54 (10.4–12.6)	8.6(8.0–9.2)	0.028^a
Hb (g/dL)	12.1 (12.1–12.2)	13.1 (13.0–13.2)	0.012^a
MCV (fl)	89.8 (83.2–96.5)	91.3 (88.2–94.4)	0.487^a
RDW (%)	12.9 (12.4–13.4)	12.7 (12.6–12.9)	0.254^a
PLT count (10^3/µL)	352 (336–368)	330 (326–335)	0.976^a
MPV (fl)	7.8 (7.3–8.4)	8.3 (8.2–8.5)	0.646^a
Neutrophil (%)	74.9 (71.3–78.5)	80.9 (78.5–83.4)	0.652^a
Neutrophil count (10^3/µL)	8.6 (8.2–9.0)	6.9 (6.7–7.2)	0.256^a
Lymphocyte count (10^3/µL)	2.1 (1.5–2.8)	1.2 (0.9–1.5)	0.036^a
Monocyte count (10^3/µL)	0.44 (0.43–0.45)	0.2 (0.2–0.3	0.350^a
NLR	4.2 (3.2–5.3)	5.98 (4.7–7.2)	0.449^a
PLR	173.2 (129.6–216.8)	286.2 (221.9–350.6)	0.050^a
LMR	5.0 (3.4–6.6)	5.6 (5.2–6.0)	0.741^a
CA125 (U/mL)	29.4 (7.9–50.8)	23.6 (22.4–24.7)	0.206^a
AMH	6.5 (5.0–8.0)	7.0 (2.1–11.9)	0.279^a
Laterality
Right (%)	2 (33)	14 (45)	0.68^b
Left (%)	4 (67)	17 (55)	0.68^b
Operative method
Laparoscopy (%)	4 (66)	25 (80)	0.47^b
Laparotomy (%)	2 (34)	6 (20)	0.47^b
Type of operation
Cystectomy (%)	0	10 (32)	0.002^b
Oophorectomy (%)	6 (100)	21 (68)	0.002^b

Notes: Values are mean±standard deviation, median (Min-Max), or absolute numbers (percentage). ^aMann Whitney Test, ^bFisher’s exact test.

Abbreviations: WBC, white blood cell; Hb, Hemoglobin; MCV, mean corpuscular volume; RDW, red cell distribution width; MPV, mean platelet; NLR, neutrophil to lymphocyte ratio; PLR, platelet to lymphocyte ratio; LMR, lymphocyte to monocyte ratio; CA 125, cancer antigen 125; CA 19–9, carbohydrate antigen; AMH, anti-müllerian hormone.

Table 3 Logistic Regression Model of WBC Count, Neutrophil Percent, Neutrophil Count, and Neutrophil to Lymphocyte Ratio with Torsion on Mature Cystic Teratomas

Characteristics	Univariate Analysis		Multivariate Analysis
	OR (95% CI)	p-value	OR (95% CI)	p-value
WBC count (10^3/µL)	1.142 (1.007–1.295)	0.039
Neutrophil (%)	1.078(1.039–1.118)	<0.001	0.741(0.618–0.888)	0.001
Neutrophil count (10^3/µL)	1.000(1.000–1.000)	0.004
NLR	1.096 (1.001–1.199)	0.046

Abbreviations: WBC, white blood cell; NLR, neutrophil to lymphocyte ratio; OR, odds ratio; CI, confidence interval.

Table 4 Logistic Regression Model of WBC Count, Hemoglobin, Lymphocyte Count, Platelet to Lymphocyte Ratio for Infarction in Torsion

Characteristics	Univariate Analysis		Multivariate Analysis
	OR (95% CI)	p-value	OR (95% CI)	p-value
WBC count (10^3/µL)	1.459(1.008–2.11)	0.045	1.97(1.03–3.74)	0.039
Hb (g/dL)	0.330(0.125–0.870)	0.025	0.26(0.078–0.894)	0.032
Lymphocyte count (10^3/µL)	6.014(1.263–28.64)	0.024
PLR	0.984(0.967–1.001)	0.068

Abbreviations: WBC, white blood cell; Hb, hemoglobin; PLR, platelet to lymphocyte ratio; OR, odds ratio; CI, confidence interval.

Table 5 Diagnostic Values of Affecting Variables for Mature Cystic Teratoma with Torsion

Variables	AUC (95% CI)	p-value	Cut-Off Value	Sensitivity (%)	Specificity (%)
WBC count (10^3/µL)	0.693(0.602–0.784)	0.001	7.36	82.9	62.4
Neutrophil (%)	0.764(0.675–0.852)	<0.001	67.6	88.6	62.4
Neutrophil count (10^3/µL)	0.723(0.634–0.812)	<0.001	4.75	88.6	63.4
NLR	0.751(0.661–0.840)	<0.001	2.80	88.6	64.5

Abbreviations: WBC, white blood cell; NLR, neutrophil to lymphocyte ratio, AUC, area under the curve; CI, confidence interval.

Table 6 Diagnostic Values of Affecting Variables for Necrosis in OMCT with Torsion

Variables	AUC (95% CI)	P-value	Cut-Off Value	Sensitivity (%)	Specificity (%)
WBC count (10^3/µL)	0.805(0.653–0.956)	0.020	9.73	83.3	75.9
Hb (g/dL)	0.233(0.011–0.454)	0.042	10.25	100	3.4
Lymphocyte count (10^3/µL)	0.773(0.512–1.00)	0.038	1.91	66.7	89.7
PLR	0.253(0.027–0.479)	0.060	87.1	100	0

Abbreviations: WBC, white blood cell; Hb, hemoglobin; PLR, platelet to lymphocyte ratio; AUC, area under the curve; CI, confidence interval.

Figure 1 Receiver operating curve of affecting variables to diagnose mature ovarian teratoma with torsion. Combination consists of WBC count, neutrophil percent, neutrophil count, and NLR.

Abbreviations: WBC, white blood cells; NLR, neutrophil to lymphocyte ratio.