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Original Article · Open access

Does the preoperative neutrophil-to-lymphocyte ratio have a prognostic value in aneurysmal bone cysts?

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İbrahim Kaya

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0001-8205-6515

Batuhan Ayhan

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0001-5848-1618

Coşkun Ulucaköy

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0002-6991-5511

Güray Toğral

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0002-2489-9335

Bedii Şafak Güngör

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0002-1339-0840

Abstract

Objectives: The aim of this study was to evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-tomonocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in aneurysmal bone cysts (ABCs).

Patients and methods: Between February 2001 and August 2019, a total of 86 patients (44 males, 42 females; mean age: 21.5±15.2 years; range, 2 to 73 years) with a histologically confirmed diagnosis of ABCs who did not receive cancer treatment previously and had a minimum follow-up period of 24 months were retrospectively analyzed. Data including age, sex, side, tumor location, pre-treatment complete blood count analysis results, preferred surgical method, follow-up period, presence of recurrence, and date of recurrence were recorded. Preoperative NLR, LMR and PLR values were calculated in all patients.

Results: The mean follow-up was 56.7±13.5 (range, 24 to 179) months. Forty-one (47.7%) ABCs were located in the lower extremities, 36 (41.8%) in the upper extremities, and nine (10.4%) in the pelvic girdle. A statistically significant difference was detected in the NLR values according to recurrence status (p=0.023). The PLR and LMR values were not significant for area under the curve, while NLR values were significant for recurrence. The cut-off value was determined as 2.054. Those with an NLR of ≥2.054 were found to have a 4.561-fold higher risk of recurrence than those with an NLR of <2.054 (odds ratio [OR]=4.561).

Conclusion: Our study results suggest that NLR, which is the pre-treatment inflammatory index, is a prognostic factor in patients with ABCs. Although NLR alone is not decisive in patients with elevated NLR, it can be used to evaluate the clinical prognosis and recommend an appropriate treatment strategy.

Declarations

Ethics Committee Approval

The study protocol was approved by the University of Health Sciences Dr. Abdurrahman Yurtaslan Oncology Health Practice and Research Center Clinical Research Ethics Committee (date: 09.062021, no: 2021-06/1152). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/concept and design: İ.K., C.U.; Data collection and/or processing: İ.K., B.A.; Analysis and/or interpretation and control/supervision: İ.K., G.T., B.S.G.; Literature review: B.A., İ.K.; Writing the article: İ.K., C.U., B.A.; Critical review: G.T., B.S.G.; References and fundings: İ.K., C.U., B.A.; Materials: G.T., C.U.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Patient Consent for Publication

A written informed consent was obtained from each patient and/or the parents of the patients.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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