Delta neutrophil index and red blood cell distribution width as new markers to predict endometriosis

Abstract

Objective: The study aimed to evaluate the efficacy of delta neutrophil index (DNI) in predicting endometriosis.

Material and methods: A retrospective case-control study was performed in a tertiary care center. DNI, red cell distribution width (RDW), and other blood parameters obtained from the complete blood count of 267 patients, consisting of 122 endometriosis patients with proven pathology reports of stages 3-4, and a control group of 145 people who underwent laparoscopy for simple ovarian cyst and/or diagnostic purposes and had normal findings in the pathology, were compared between the two groups. ROC and logistic regression analyses were performed.

Results: DNI and RDW were significantly higher in endometriosis patients than in the control group (p=0.034, 0.003, respectively). For parameters calculated from other complete blood counts (leukocyte, neutrophil, lymphocyte, monocytes, platelet, NLR), there was no difference between the two groups (P>0.05). For DNI, at a cut-off value of 0.025, AUC was 0.572 and it was statistically significant (p=0.042; 95%CI=0.503- 0.642, sensitivity: 45.9%, specificity: 67.6 %, Youden's Index = 0.135). For RDW, AUC=0.601 for cut-off value of 13.65 was statistically significant (p= 0.004, 95% CI= 0.553- 0.669, sensitivity= 50.8%, specificity= 67.6 %, Youden's Index= 0.184). The logistic regression model established with the combined marker obtained by multiplying the DNI and RDW was statistically significant (p<0.001, Nagelkerke R2=0.72, 95% CI=2.58- 47.26, B: 2.40, NPV=78.6 %, PPV=37.7 %).

Conclusion: DNI, a new inflammatory marker, and RDW, known to be associated with inflammation, seem to be useful for clinically diagnosing endometriosis without the need for surgery.