Ginekol Pol.

2014, 85, 197-203 P R A C E O R Y G I N A L N E

po ł o ż n i c t wo

Mean Platelet Volume, Neutrophil-Lymphocyte

Ratio and Platelet-Lymphocyte Ratio in Severe
Preeclampsia

Średnia objętość płytek krwi, wskaźnik neutrofile/limfocyty oraz wskaźnik

płytki krwi/limfocyty w ciężkiej preeklampsji

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(OLI<ÕOGÕ]16ÕWNÕg]ELOJHo16HODKDWWLQ.XPUX1

1
Department of Obstetrics and Gynecology, Düzce University Faculty of Medicine, Düzce, Turkey
2
Department of Obstetrics and Gynecology, International Medicana Hospital, İstanbul, Turkey

Abstract
Objectives: The aim of the study was to compare the changes in the values of leukocytes, neutrophils, lymphocy-
tes, mean platelet volume (MPV), and systemic inflammatory response (SIR) markers (neutrophil-lymphocyte ratio/
platelet-lymphocyte ratio) in patients with severe preeclampsia (PE) of healthy pregnant and non-pregnant women.
Material and methods: Hematological parameters including MPV, and SIR markers [neutrophil-lymphocyte ratio
(NLR), platelet-lymphocyte ratio (PLR)] were compered between the between three groups comprising of women
with severe PE, healthy pregnant women and healthy non-pregnant women.
Results: MPV and PLR did not show statistically significant differences between the three groups (p=0.081,
p=0.098). NLR showed a statistically significant difference between the three groups (p=0.000). NLR values of
patients with severe PE were statistically significantly higher than healthy non-pregnant women (p=0.000). No sta-
tistically significant difference was found between patients with severe PE and healthy pregnant women (p=0.721).
The cut-off value of the leukocyte number for severe PE was 7.6 x 103/ml, with 76.7% sensitivity and 60.6% speci-
ficity. The cut-off value of neutrophil number was 6.4 x 103/ml for the group with severe PE, with 76.7% sensitivity
and 69% specificity.

Corresponding author:
Ali Yavuzcan
Department of Obstetrics and Gynecology, Duzce University School of Medicine,
81000, Konuralp, Duzce, Turkey
Otrzymano: 31.05.2013
mobile: +90 (532) 634 54 31
Zaakceptowano do druku: 16.10.2013
e-mail: draliyavuzcan@yahoo.com

Nr 3/2014 © Polskie Towarzystwo Ginekologiczne 197

P R A C E O R Y G I N A L N E Ginekol Pol. 2014, 85, 197-203
poł ożn i ct wo

Ali Yavuzcan et al. Mean Platelet Volume, Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Severe Preeclampsia.

Conclusions: Our results showed that MPV level did not differ among patients with severe PE, healthy pregnant
women and non-pregnant women. NLR cannot be used to identify patients with severe PE. PLR measured before
termination of pregnancy is not an effective marker for severe PE, either.

Key words leukocytes / mean platelet volume / neutrophils / neutrophil-lymphocyte

ratio / platelet-lymphocyte ratio / preeclampsia /

Streszczenie
Celem badania było porównanie zmian w ilości leukocytów, neutrofilów, limfocytów, średniej objętości płytek krwi
(MPV) a układową odpowiedzią zapalną (SIR)wyrażoną za pomocą markerów (wskaźnik neutrofile/limfocyty oraz
wskaźnik płytki krwi/limfocyty) u pacjentek z ciężką preeklampsją (PE), u zdrowych ciężarnych i u nieciężarnych
kobiet.
Materiał i metoda: Parametry hematologiczne oraz MPV i markery SIR (wskaźnik neutrofile/limfocyty NRL oraz
wskaźnik płytki krwi/limfocyty PLR) zostały porównane między trzema grupami pacjentek: z ciężką preeklampsją,
zdrowymi ciężarnymi i zdrowymi nieciężarnymi kobietami.
Wyniki: MPV oraz PLR nie wykazały istotnych różnic pomiędzy porównywanymi grupami (p=0,081, p=0,098).
NRL różniło się istotnie w badanych grupach (p=0,000). Wartości NRL były istotnie wyższe w grupie z ciężką PE
niż u zdrowych nieciężarnych kobiet (p=0,000). Nie znaleziono istotnej różnicy pomiędzy pacjentkami z ciężką PE
a zdrowymi ciężarnymi (p=0,721). Punkt odcięcia liczby leukocytów dla ciężkiej PE wynosił 7,6x103/ml, przy 76,7%
czułości i 60,6% specyficzności. Punkt odcięcia liczby neutrofili dla ciężkiej PE wynosił 6,4x103/ml, przy 76,7%
czułości i 69% specyficzności.
Wnioski: Nasze wyniki pokazują, że poziom MPV nie różni się pomiędzy pacjentkami z ciężką preeklampsją, zdro-
wymi ciężarnymi i zdrowymi nieciężarnymi kobietami. NRL nie może być wykorzystany do identyfikacji pacjentek
z ciężką PE. Również pomiar PRL przed zakończeniem ciąży nie jest skutecznym markerem ciężkiej PE.

Słowa kluczowe: leukocyty / ĞreGnia oEMĊtoĞü páytek krZi / neutro¿le / ZskaĨnik

neutro¿le-limIocyty / ZskaĨnik páytki krZi-limIocyty / preeklampsja /

List of abbreviations:
PE, preeclampsia; MPV, mean platelet volume; SIR, systemic
inflammatory response NLR, neutrophil-lymphocyte ratio; PLR,
platelet-lymphocyte ratio; g/dL, GramsPerDeciLiter; fL, FemtoLiter;
/uL, PerMicroLiter; 103/uL, ThousandPerMicroLiter; Hb, Hemoglobin;
ROC, Receiver operating characteristic
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198 © Polskie Towarzystwo Ginekologiczne Nr 3/2014

Ginekol Pol. 2014, 85, 197-203 P R A C E O R Y G I N A L N E
po ł o ż n i c t wo

Ali Yavuzcan et al. Mean Platelet Volume, Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Severe Preeclampsia.

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Nr 3/2014 © Polskie Towarzystwo Ginekologiczne 199

P R A C E O R Y G I N A L N E Ginekol Pol. 2014, 85, 197-203
poł ożn i ct wo

Ali Yavuzcan et al. Mean Platelet Volume, Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Severe Preeclampsia.

Table I. Patient characteristics.

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Table II. Comparison of hematological parameters and NLR -PLR values.

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P value*
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 0  0.000
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Table III. Bilateral comparison of MPV, NLR and PLR values between the groups.

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P value a P value b P value c
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Figure 1. Correlation between leukocyte number and severe PE. Figure 2. Correlation between neutrophil number and severe PE.

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Ali Yavuzcan et al. Mean Platelet Volume, Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Severe Preeclampsia.

Authors’ Contribution 20. Stubbs TM, Lazarchick J, Van Dorsten JP, [et al.]. Evidence of accelerated platelet production
and consumption in nonthrombocytopenic preeclampsia. Am J Obstet Gynecol. 1986, 155 (2),
1. Ali Yavuzcan – study design, methodology, interpretation of results and 263–265.
writing of the text – corressponding author.
21. Boriboonhirunsarn D, Atisook R, Taveethamsathit T. Mean platelet volume of normal pregnant
2. Mete Çağlar – study design and methodology. women and severe preeclamptic women in Siriraj Hospital. J Med Assoc Thai. 1995, 78 (1),
3. Yusuf Üstün – statistical analysis. 586–589.
22. Wieczorek A, Wilczyński JR, Malinowski A, [et al.]. Parameters of peripheral whole blood
4. Serdar Dilbaz – Study design
neutrophil activity in women with pregnancy induced hypertension. Ginekol Pol. 2001, 72 (12),
5. İsmail Özdemir – Scientific control of the text. 1222-1227.
6. Elif Yıldız – data collection. 23. Tasoglu I, Sert D, Colak N, [et al.]. Neutrophil-Lymphocyte Ratio and the Platelet-Lymphocyte
Ratio Predict the Limb Survival in Critical Limb Ischemia. Clin Appl Thromb Hemost. 2013 Feb
7. Sıtkı Özbilgeç – data collection. 6. (Epub ahead of print).
8. Selahattin Kumru – scientific control of the text. 24. Suppiah A, Malde D, Arab T, [et al.]. The prognostic value of the neutrophil-lymphocyteratio (nlr)
in acute pancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013, 17 (4), 675-
681.
Authors’ statement
25. Klinger MH, Jelkmann W. Role of blood platelets in infection and inflammation. J Interferon
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Cytokine Res. 2002, 22 (9), 913–922.
currently under consideration for publication elsewhere. 26. Wegmann TG, Lin H, Guilbert L, Hormann TR. Bidirectional cytokine interactions in the maternal-
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SX^O\O]^] fetal relationship: is successful pregnancy a TH2 phenomenon? Immunol Today. 1993, 14 (7),
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Gynecology will inform our institutions employing us Turkish Ministry of 27. Bhatti I, Peacock O, Lloyd G, [et al.]. Preoperative hematologic markers as independent
Health and Turkish Society of Obstetrics and Gynecology. We are members predictors of prognosis in resected pancreatic ductal adenocarcinoma: neutrophil-lymphocyte
versus platelet-lymphocyte ratio. Am J Surg. 2010, 200 (2), 197–203.
of these institutions.
28. Turkmen K, Erdur FM, Ozcicek F, [et al.]. Platelet-to-lymphocyte ratio better predicts inflammation
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than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013, 17
article. (3), 391-396.
29. Laskin S, Payne B, Hutcheon JA, [et al.]. The role of platelet counts in the assessment of
inpatient women with preeclampsia. J Obstet Gynaecol Can. 2011, 33 (9), 900-908.

Refe re nc e s

1. ACOG. American College of Obstetricians and Gynecologists. News Releases. A Push to End
Preeclampsia. May 7, 2012.
2. Ahmed A, Cudmore M. Can the biology of VEGF and haemoxygenases help solve pre-
eclampsia? Biochem Soc Trans. 2009, 37, 1237–1242.
3. Savill J. The fate of the neutrophil in vasculitis. Clin Exp Immunol. 1993, 93, 2-5.
4. Ramma W, Buhimschi IA, Zhao G, [et al.]. The elevation in circulating anti-angiogenic factors is
independent of markers of neutrophil activation in preeclampsia. Angiogenesis. 2012, 15 (3),
333-340.
5. Clark P, Boswell F, Greer IA. The neutrophil and preeclampsia. Semin Reprod Endocrinol. 1998,
16 (10), 57–64.
6. Celikbilek M, Dogan S, Ozbakır O, [et al.]. Neutrophil-lymphocyte ratio as a predictor of disease
severity in ulcerative colitis. J Clin Lab Anal. 2013, 27 (1), 72-76.
7. Imtiaz F, Shafique K, Mirza SS, [et al.]. Neutrophil lymphocyte ratio as a measure of systemic
inflammation in prevalent chronic diseases in Asian population. Int Arch Med. 2012, 5 (1), 2.
8. Proctor MJ, Morrison DS, Talwar D, [et al.]. A comparison of inflammation-based prognostic
scores in patients with cancer. A Glasgow Inflammation Outcome Study. Eur J Cancer. 2011,
47 (17), 2633–2641.
9. ACOG .American College of Obstetricians and Gynecologists practice bulletin. Diagnosis and
management of preeclampsia and eclampsia. Int J Gynaecol Obstet. 2002, 77 (1), 67-75.
10. Turgut A, Sak ME, Ozler A, [et al.]. Alteration of peripheral blood cells in tubal ectopic pregnancy.
Ginekol Pol. 2013, 84 (3), 193-196.
11. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between
thrombosis and inflammation? Curr Pharm Des. 2011, 17 (1), 47-58.
12. Dundar O, Yoruk P, Tutuncu L, [et al.]. Longitudinal study of platelet size changes in gestation
and predictive power of elevated MPV in development of pre-eclampsia. Prenat Diagn. 2008,
28 (11),1052–1056.
13. Altınbas S, Toğrul C, Orhan A, [et al.]. Increased MPV is not a significant predictor for
preeclampsia during pregnancy. J Clin Lab Anal. 2012, 26 (3),403-406.
14. Edelstam G, Lowbeer C, Kral G, [et al.]. New reference values for routine blood samples and
human neutrophilic lipocalin during third-trimester pregnancy.Scand J Clin Lab Invest. 2001, 61
(8), 583–592.
15. Canzoneri BJ, Lewis DF, Groome L, Wang Y. Increased neutrophil numbers account for
leukocytosis in women with preeclampsia. Am J Perinatol. 2009, 26 (10), 729-732.
16. Järemo P, Lindahl TL, Lennmarken C, Forsgren H. Theuse of platelet density and volume
measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest. 2000, 30 (12), 1113-
1118.
17. Ceyhan T, Beyan C, Başer I, [et al.]. The effect of pre-eclampsia on complete blood count,
platelet count and mean platelet volume. Ann Hematol. 2006, 85 (5), 320-322.
18. Bain BJ. Ethnic and sex differences in the total and differential white cell count and platelet
count. J Clin Pathol. 1996, 49 (8), 664-666.
19. Kuscu NK, Kurhan Z, Yildirim Y, [et al.]. Detection of endothelial dysfunction in preeclamptic
patients by using color Doppler sonography. Arch Gynecol Obstet. 2003, 268 (2), 113–116.

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