RT Journal Article SR Electronic T1 Neutrophil-, Monocyte- and Platelet-to-Lymphocyte Ratios, and Absolute Lymphocyte Count for Diagnosis of Malignant Soft-tissue Tumors JF Anticancer Research JO Anticancer Res FD International Institute of Anticancer Research SP 3349 OP 3357 DO 10.21873/anticanres.16511 VO 43 IS 7 A1 MIHARA, ATSUSHI A1 IWANAGA, RYUTA A1 YUKATA, KIMINORI A1 FUJII, KENZO A1 MURAMATSU, KEIICHI A1 IHARA, KOICHIRO A1 SAKAI, TAKASHI YR 2023 UL http://ar.iiarjournals.org/content/43/7/3349.abstract AB Background/Aim: Soft-tissue tumors are difficult to differentiate as benign or malignant. Immune markers, such as the neutrophil–lymphocyte ratio (NLR), monocyte–lymphocyte ratio (MLR), platelet–lymphocyte ratio (PLR), and absolute lymphocyte count (ALC) in serum, have been reported to be useful in the diagnosis and predicting prognosis of several malignancies. We investigated the diagnostic value of these immune markers in differentiating soft-tissue tumors. Patients and Methods: A total of 692 patients who underwent biopsy or surgery of soft-tissue tumors were included and divided into benign tumor, low-grade malignancy, or high-grade malignancy groups. Immune markers were calculated from the preoperative blood tests and compared between the groups. A receiver operating curve (ROC) analysis was conducted between the benign disease group and a combination of the groups with malignancy to determine which immune marker had the most diagnostic value. Results: NLR and MLR were significantly different between the three groups with benign disease having the lowest value and high-grade malignancies the highest. Benign disease was also associated with lower PLR and higher ALC. There was no difference between the low- and high-grade malignancies in PLR and ALC. From the ROC analysis, NLR had the highest area under the curve (AUC) value of 0.773 out of the four markers. When limited to small tumors (≤30 mm), NLR had the highest AUC value of 0.729. Conclusion: The NLR showed the highest diagnostic value, although the diagnostic ability was not adequately high to differentiate benign and malignant soft-tissue tumors alone. NLR may serve as diagnostic support in combination with clinical history, physical findings, and tumor-imaging results.