Malignancies like hepatocelluar carcinoma, carcinoma stomach, aplastic anemia, prostate cancer which can be easily missed if not strongly suspected, these group of population generally reach the hospital at the later stage of the diseases where their treatment option becomes limited. In this study, we have evaluated the predictive and prognostic utility of NLR, PLR and MPV for earlier predicting as a biomarker.
We have conducted this study by screening all the patients who got admitted between January 2013 and June 2017. The data collected were analyzed for neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, mean platelet of 100 cases in each group of hepatocellular carcinoma, carcinoma stomach, aplastic anemia, prostate cancer. Control group of with no known comorbidities were taken to find the normal cut off value of NLR, PLR and MPV and was validated with other similar studies. Inclusion criteria were all the patients with admitted with a diagnosis of hepatocellular carcinoma, carcinoma stomach, aplastic anemia, prostate cancer. Exclusion criteria: all cases other than the test group. Patients with other associated malignancies and inflammatory state.
Male preponderance was seen in all the malignancies. The incidence of hepatocellular carcinoma was more in the low socio-economic group where other malignancies were equally prevalent in all the socio-economic groups. NLR and PLR were highly significant with a p – value 0.001 and p – 0.001 to be used as a biomarker in predicting the malignant conditions. MPV was statistically insignificant to use a prognostic biomarker.
From our study, we conclude that NLR, PLR are better and cost-effective predictor and prognostic biomarker in malignant condition. These ratios of NLR and PLR can be interpreted from a peripheral smear at the primary health care level in rural part of the developing country like India. This simple and cost-effective test will reduce the financial burden and better patient care in early identification and monitoring the prognosis of diseases.
Dr. V.S. Srikanth
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All authors have declared no conflicts of interest.