Association of ultrasound findings with hematological parameters, cytokines and survival in ovarian cancer

Background: The objectives of the study were to evaluate the association of ultrasound findings with hematologic parameters, tumor markers and serum cytokines in malignant adnexal neoplasms and borderline tumors; and to evaluate the association of these findings with overall survival (OS) and disease-free survival (DFS). Methods: The study included 33 patients with a confirmed pathological diagnosis of borderline ovarian tumor (n = 10) and malignant ovarian/tube neoplasm (n = 23). The anatomopathological, tumor markers, hematologic parameters, serum cytokine levels (interleukin (IL)-2, IL-5, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-alpha) and ultrasound findings (adnexal mass volume and largest diameter, vegetation, solid areas, septa, thickness of the capsule, vascularization on Doppler) were evaluated. Comparison of values between groups was performed using the Mann-Whitney test. Survival was assessed using Kaplan-Meier curves and log-rank test. The significance level was 0.05. Results: Shorter OS and DFS were demonstrated in patients with a tumor volume greater than 245 mL and ovarian cancer (p = 0.031 and p = 0.024, respectively). Moreover, there was an association between higher red cell distribution width (RDW) value and the presence of thick septa (p = 0.0355), and tumor volume >245 mL with lower levels of hemoglobin (p = 0.0102) and hematocrit (p = 0.0095), levels more elevation of serum IL-8 (p = 0.0453) and higher levels of neutrophil-lymphocyte ratio (NLR) (p = 0.0227). The presence of vascularization on Doppler was associated with higher platelet values (p = 0.0339). Regarding borderline tumors, no association between ultrasound, laboratory parameters and survival was demonstrated. Conclusions: Ultrasonographic findings in adnexal masses may reflect parameters of systemic inflammatory and immunological response in ovarian cancer. In particular, greater tumor volume is associated with lower OS and DFS.

Ultrasonographic findings; Ovarian tumor; Hematologic parameters; Citokynes; Survival

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