Evaluation of the predictive role of neutrophil/lymphocyte ratio in the diagnosis of lymphoma in patients with asymptomatic and ısolated cervical lymphadenopathy

INTRODUCTION: The diagnostic approach to patients with isolated asymptomatic cervical lymphadenopathy varies between excisional biopsy and follow-up. When the anamnesis, physical examination, laboratory and imaging findings are not sufficient to identify the etiology, an excisional biopsy is performed for the differential diagnosis between early-stage lymphoma and infectious or reactive causes. If the excisional biopsy, which may have some complications, is not performed, it may delay the diagnosis of lymphoma. This diagnostic challenge could be avoided by predictive markers. OBJECTIVES: This study was planned to determine the predictive value of neutrophil/lymphocyte ratio in the diagnosis of Hodgkin and non-Hodgkin limphoma in patients with asymptomatic, isolated cervical limphadenopathy and underwent excisional biopsy. METHODS: A total of 90 patients between the years 2016 − 2019 admitted to our clinics due to asymptomatic isolated cervical lymphadenopathy, present in at least 4 weeks with lympho nodes in pathological dimensions persisting in the cervical region, were included to our study. An excisional lympho node biopsy was performed in all 90 patients. RESULTS: Of the 90 patients who underwent excisional biopsy; 34 were diagnosed as reactive lymphadenopathy 30 were non-Hodgkin linphoma, and 26 were Hodgkin linphoma. A total of 56 (62.2%) patients were diagnosed as lymphoma, either Hodgkin or non-Hodgkin, while 34 patients (38.8%) were diagnosed as reactive lymphadenopathy. The median age, total whiteblood count, neutrophil count of the lymphoma groups were significantly higher than reactive lymphadenopathy group, whereas the lymphocyte count was significantly lower in the lymphoma patients. The median neutrophil/ lymphocyte ratio was 1.7 in the reactive lymphadenopathy group, 3.5 in the non-Hodgkin limphoma group, and 3.0 in the Hodgkin limphoma group (p < 0.001). CONCLUSION: According to the results of our study, neutrophil/lymphocyte ratio was significantly higher in patients who were admitted with isolated asymptomatic lymphadenopathy and were diagnosed with lymphoma, and who were diagnosed with early-stage Hodgkin and non- Hodgkin lymphoma compared to those who were found to have reactive lymphadenopathy. Neutrophil/lymphocyte ratio, which is a low-cost, fast and easy-to-access test, has a predictive value in the diagnosis of lymphoma in patients with asymptomatic lymphadenopathy.