AI Summary & Key Takeaways
AI InsightHowever, these findings should be considered explor- atory, and further prospective studies are required be- fore clinical implementation can be recommended.
📌 3 Key Takeaways
Abstract
Objective To evaluate the prognostic significance of fragmented QRS (fQRS) on electrocardiography and the neutro- phil-to-lymphocyte ratio (NLR) as noninvasive bio- markers in endometrial cancer, with particular focus on their association with lymphovascular space inva- sion (LVSI). Material and Method In this retrospective cohort study, 198 patients who underwent surgery for endometrial cancer were in- cluded. All cases were staged according to the 2023 FIGO classification. Preoperative complete blood counts and electrocardiograms were assessed to de- termine NLR and the presence of fQRS. Clinicopath- ological variables, including LVSI status, were record- ed and statistically analyzed. Results The median NLR was significantly higher in patients with fragmented QRS compared with those with- out fragmented QRS (2.45 [1.46–12.42] vs. 2.04 [0.66–7.72], p = 0.013). LVSI positivity was observed more frequently among patients with fQRS (30% vs. 11.3%, p = 0.007). ROC curve analysis identified an optimal NLR cut-off value of 2.4 for predicting substan- tial LVSI (AUC = 0.62, 95 % CI: 0.55–0.69, p = 0.013), with a sensitivity of 64.3% and specificity of 58.2%. Multivariable logistic regression analysis demonstrat- ed that higher BMI (OR: 1.07, 95% CI: 1.01–1.14, p = 0.031), smoking (OR: 2.84, 95% CI: 1.18–6.84, p = 0.020), hypertension (OR: 0.38, 95% CI: 0.15–0.96, p = 0.041), and LVSI positivity (OR: 3.21, 95% CI: 1.24– 8.31, p = 0.016) were independently associated with the presence of fragmented QRS. Conclusion Both fQRS and NLR were associated with LVSI in pa- tients with endometrial cancer and may reflect adverse pathological features related to tumor aggressiveness. However, these findings should be considered explor- atory, and further prospective studies are required be- fore clinical implementation can be recommended.
Özet
Objective To evaluate the prognostic significance of fragmented QRS (fQRS) on electrocardiography and the neutro- phil-to-lymphocyte ratio (NLR) as noninvasive bio- markers in endometrial cancer, with particular focus on their association with lymphovascular space inva- sion (LVSI). Material and Method In this retrospective cohort study, 198 patients who underwent surgery for endometrial cancer were in- cluded. All cases were staged according to the 2023 FIGO classification. Preoperative complete blood counts and electrocardiograms were assessed to de- termine NLR and the presence of fQRS. Clinicopath- ological variables, including LVSI status, were record- ed and statistically analyzed. Results The median NLR was significantly higher in patients with fragmented QRS compared with those with- out fragmented QRS (2.45 [1.46–12.42] vs. 2.04 [0.66–7.72], p = 0.013). LVSI positivity was observed more frequently among patients with fQRS (30% vs. 11.3%, p = 0.007). ROC curve analysis identified an optimal NLR cut-off value of 2.4 for predicting substan- tial LVSI (AUC = 0.62, 95 % CI: 0.55–0.69, p = 0.013), with a sensitivity of 64.3% and specificity of 58.2%. Multivariable logistic regression analysis demonstrat- ed that higher BMI (OR: 1.07, 95% CI: 1.01–1.14, p = 0.031), smoking (OR: 2.84, 95% CI: 1.18–6.84, p = 0.020), hypertension (OR: 0.38, 95% CI: 0.15–0.96, p = 0.041), and LVSI positivity (OR: 3.21, 95% CI: 1.24– 8.31, p = 0.016) were independently associated with the presence of fragmented QRS. Conclusion Both fQRS and NLR were associated with LVSI in pa- tients with endometrial cancer and may reflect adverse pathological features related to tumor aggressiveness. However, these findings should be considered explor- atory, and further prospective studies are required be- fore clinical implementation can be recommended.