Pre-treatment diagnosis of endometrial cancer through a combination of CA125 and multiplication of neutrophil and monocyte

Aim: This study aimed to investigate the clinical value of pre-treatment leukocyte differential counts and the prediction of endometrial cancer using leukocyte markers. Material and Methods: Medical records of 238 women with pathologically confirmed endometrial cancer between March 2000 and June 2009 at two Korean hospitals were reviewed and compared to 596 healthy people visiting the Health Promotion Center in Gangnam Severance Hospital. For all study subjects, leukocyte differential counts and CA125 levels in serum obtained prior to operation were recorded. Multiplication of neutrophil and monocyte (MNM) was determined by multiplying neutrophil and monocyte counts then dividing by 10 000. Differences between endometrial cancer patients and healthy controls were compared. The sensitivity and specificity for each marker as well as the combined use of CA125 and other leukocyte markers were assessed using receiver operating characteristic curves. Results: Mean white blood cell (WBC) counts were 6676 (6440-6913) cells/mu L in endometrial cancer patients compared to 5663 (5542-5784) cells/mu L in healthy controls (P < 0.001). The area under curve (AUC) for CA125 was 0.689 with a sensitivity of 49.13% and specificity of 83.1% using an optimal cut-off value of 18.7 U/mL. The AUC for MNM was 0.696 with a sensitivity of 62.9% and specificity of 69.1%. The combination of CA125 and MNM showed a higher AUC of 0.760 than use of CA125 or MNM alone. Conclusion: The combination of MNM and CA125 is a simple and cost-effective method for predicting endometrial cancer.