Malignancy in adrenal incidentalomas: Are Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio significant?

INTRODUCTION: The aim of this study was to assess the potential of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as diagnostic and prognostic parameters in predicting the malignancy potential of adrenal incidentalomas (AI).
METHODS: A retrospective analysis was conducted using data from a prospectively maintained database, including 66 patients with AI. The patients were categorized into two groups: Group M (malignancies) and Group B (benign conditions).
RESULTS: Postoperative pathological evaluation revealed adrenocortical cancer in eight patients (12.1%). No statistically significant differences were found between the groups in terms of NLR [Group M: 2.94 ± 1.78, Group B: 2.51 ± 1.08, p = 0.335] and PLR [Group M: 136.90 (98.7-354.05), Group B: 118.39 (28.5-315.32), p = 0.479]. However, analysis of adrenal mass size revealed a statistically significant difference, with Group M having a mean size of 80.5 mm (range: 40-146) and Group B having a mean size of 60.5 mm (range: 40-122) (p = 0.008).
DISCUSSION AND CONCLUSION: While NLR and PLR showed numerical increases in malignant adrenal masses, their utility in differentiating between benign and malignant masses was not significant. Further investigation of NLR and PLR in larger cohorts of patients with AI is recommended to better understand their diagnostic and prognostic value in this context.