Relationship between endometrial thickness and neutrophil/lymphocyte ratio with endometrial malignancy in 386 postmenopausal uterine bleeding cases

Introduction
In our study, endometrial thickness with neutrophil/lymphocyte ratio and endometrial sampling results were compared in terms of outcome in women with postmenopausal bleeding. In addition, we aimed to determine the predictive value of endometrial thickness and neutrophil/lymphocyte ratio for predicting endometrial carcinoma.

Material and methods
Our single-centered study was performed retrospectively. The study included 386 postmenopausal women admitted to our gynecology outpatient clinic for abnormal uterine bleeding between January 2015 and June 2017 and subjected to endometrial sampling.

Results
The mean endometrial thickness for endometrial hyperplasia was calculated as 13 mm (min. 4 mm, max. 20 mm) and for endometrial carcinoma 17.19 mm (min. 8 mm, max. 27 mm). The neutrophil count and neutrophil/lymphocyte ratio (NLR) were significantly higher and the lymphocyte count was lower in the group with endometrial malignancy (p = 0.002, p < 0.001 and p = 0.011, respectively). None of the patients with endometrial thickness < 8 mm received an endometrial carcinoma diagnosis. The optimal cut-off value of endometrial thickness for detecting endometrial carcinoma was ≥ 13.50 mm, at which the sensitivity was 75% and specificity was 83.6%. The optimal cut-off value of NLR for detecting endometrial carcinoma was ≥ 2.20, at which the sensitivity was 81.3% and specificity was 60.5%.

Conclusions
Co-evaluation of NLR with endometrial thickness determined by transvaginal sonography might be useful for predicting endometrial carcinoma.