The distinctive role of systemic immune-inflammatory parameters in gestational trophoblastic diseases

Abstract

Aim: In this study, we aimed to distinguish molar pregnancies from healthy pregnancies with the parameters that make up simple hematological tests that can be easily applied in the routine and to increase diagnostic sensitivity.Material and Methods: This retrospective cohort study was conducted between January 2018 and September 2022 at the University Hospital Gynecology Clinic. The study included 80 partial hydatidiform moles (PMH), 45 complete hydatidiform moles (CMH) and 50 healthy pregnant women. Before surgical curettage in molar pregnants and in routine antenatal examinations in healthy pregnant women, white blood cell (WBC) counts, neutrophil (NC) counts, lymphocyte (LC) and platelet counts (PLT), red cell distribution width (RDW), mean platelet volume (MPV), platelet distribution width (PDW), hemoglobin (Hb) and fibrinogen results were recorded. The Neutrophil-lymphocyte ratio (NLR), Platelet-lymphocyte ratio (PLR) and systemic immune-inflammatory index (SII) were calculated based on the results of complete blood count.Results: WBC [8.5 & PLUSMN;2.30] vs [10.2 & PLUSMN;5.6]103/mm3, NC [6.05 & PLUSMN;5.56] vs [7.5 & PLUSMN;6.05]103/mm3, PDW [16.59 & PLUSMN;0.9] vs [16.87 & PLUSMN;0.75]% in PMH and CMH groups, respectively and NLR [3.23 & PLUSMN;2.4] vs [3.61 & PLUSMN;3.1], Fibrinogen [354 & PLUSMN;79]vs[347 & PLUSMN;82 ] mg/dl and SII [689.2 & PLUSMN;76.1] vs [701.16 & PLUSMN;52] were measured. These parameters were found significantly higher in molar pregnancy group then the controls. However, MPV [10.4 & PLUSMN; 0.1]fL and RDW [14.5 & PLUSMN;1.21] % values were significantly higher in healthy pregnancies than in molar pregnancies (p<0.05 for two parameters).Discussion: A higher inflammatory response is observed in molar pregnancies than in healthy pregnancies due to uncontrolled trophoblastic growth. Accelerating the diagnosis of GTD allows for early treatment with simple prognostic variables available from the measurement of peripheral blood cells.