Association of albumin, neutrophil–lymphocyte ratio and lymphocytes with clinical stage in cervical cancer patients

To determinate the association between of albumin, neutrophil–lymphocyte ratio and lymphocytes (NLR) with clinical stage in cervical cancers.

Design a retrospective cross-sectional study of consecutive subjects diagnosed with cervical cancer for the first time. The Bethesda system was used for histological diagnosis and the subjects were stratified with the FIGO system, considering stages IA to IIB as localized; while, IIIA and IVB as advanced stages. Albumin, NLR and lymphocytes were evaluated as inflammatory biomarkers and the cut-off points generated by the ROC curves were albumin < 3 mg/dL, NLR ≥ 2.0 and lymphocytes < 1.2 10³/ul. The association was calculated by Odds Ratios (OR) with 95% confidence intervals.

A total of 152 patients were analyzed, with mean age of 49.3 ± 14.0 years. Epidermoid cancer was the most frequent in 70.6% and 51.3% were classified as advanced clinical stages. A bivariate analysis showed significant relationships between advanced clinical stages and albumin < 3 mg/dL with OR 5.72 (CI95% 2.62–12.4; p < 0.001); for NLR ≥ 2.0 an OR 2.53 (CI95% 1.34–4.89; p = 0.005) and for lymphocytes < 1.2 10³/ul of OR 3.39 (CI95% = 1.73–6.65; p < 0.001).

Albumin levels < 3 mg/dL, NLR ≥ 2.0 and lymphocytes < 1.2 10³/ul, were associated with advanced stages in subjects with cervical cancer.