The Diagnostic Value of Hematological Indices in Ischemic Adnexal Torsion

Objectives: To investigate the role of hematological indices, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in the preoperative diagnosis of adnexal torsion (AT) and to examine the correlation between NLR and PLR levels to AT ischemic severity. Materials and Methods: A retrospective controlled study, assembled from 102 patients with surgically proven AT. Patients were divided into two groups based on the severity of the torsion, mild-moderate AT (MAT) and severe AT (SAT), using the Parelkar classification (gross appearance of the adnexa during surgery) and number of adnexal twists (≥3). Univariate analysis was performed, and the NLR and PLR levels were compared between the groups. A p -value of 0.05 was considered significant. Results: Among the 102 patients, 35 (34.3%) were diagnosed with SAT (study group), while 67 (65.7%) had MAT (control group). Within the study group, 7 women (20%) were pregnant, compared with 25 women (37.3%) in the control group. Age distribution did not significantly differ between the groups (mean age: 31.8 ± 8.4 years in the study group vs. 32.1 ± 7.35 years in the control group). The mean NLR in the study group was 5.23 ± 3.26, which was not significantly different from the control group’s mean NLR of 4.95 ± 3.44 ( p = 0.69). Similarly, the mean PLR was 175 ± 87.23 in the study group and 161 ± 78.39 in the control group, with no significant difference ( p = 0.41). Conclusion: The study identified elevated levels of NLR and PLR in patients with AT. However, the findings did not provide sufficient statistical evidence to establish NLR and PLR as reliable presurgical markers for the presence and severity of AT. As a result, laparoscopy continues to be the most effective diagnostic method for AT, particularly in women of reproductive age, given the critical importance of preserving ovarian function. Further research is warranted to explore the potential role of hematological biomarkers, specifically NLR and PLR, in the presurgical diagnosis of AT.