الفهرس 
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Abstract
The purpose of this study was to evaluate the applicability of neutrophil to lymphocyte ratio and platelet
to lymphocyte ratio in early differentiation between endometrial hyperplasia and endometrial cancer in cases of
abnormal uterine bleeding.
This study included 159 patients suffering from abnormal uterine bleeding during pre and postmenopausal
period, they was classified into 3 groups based on pathological diagnosis of endometrial biopsy; group (I) normal
endometrium, as control group, group (2) endometrial hyperplasia was subdivided into endometrial hyperplasia
without atypia and endometrial hyperplasia with atypia group (3) endometrial cancer.
They classified according to the result of the Histopathology as following: normal results (secretory
endometrium, atrophic endometrium and proliferative endometrium) represented 73 women as control group, 68 cases
were diagnosed as endometrial hyperplasia, subdivide into endometrial hyperplasia without atypia group [n=48], and
endometrial hyperplasia with atypia group [n=20], meanwhile, 18 endometrial samples were diagnosed as endometrial
cancer group.
A blood sample was taken from all participants, Laboratory tests included complete blood picture, prothrombin
time, activated prothrombin time and international normalized ratio (INR), random blood sugar, human chorionic
gonadotropin, HCG (women in premenopausal period), thyroid function tests (triiodothyronine T3, thyroxine T4 and
thyroid stimulating hormone TSH), liver function tests (alanine transaminase ALT, aspartate transaminase AST),
kidney function tests (serum creatinine, blood urea) were assessed to exclude systemic causes of bleeding.
Blood samples were obtained just before curettage procedure and the NLR was defined as the absolute
neutrophil count divided by the absolute lymphocyte count; similarly, PLR was defined as the absolute platelet count
divided by the absolute lymphocyte count. Also assessment of the endometrial thickness and detection of other pelvic
pathologies was done using trans-vaginal 2D ultrasound.
Dilatation and Curettage (D&C) procedure was performed in theatre under general anesthesia for all women.
Preparing the cervix for dilation was achieved with 200 micrograms of misoprostol vaginally prior to the procedure.
Appropriate antibiotics as a cephalosporin was administered as a prophylaxis. D&C is regarded as a relatively minor
operation. This technique allows for the most thorough sampling of the endometrium
NLR and PLR were studied in the studied groups and correlation of these markers was assessed with the
ultrasonography and results of D&C biopsy in endometrial cancer and endometrial hyperplasia groups, determination
Summary
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of the best cutoff value of these hematological markers in differentiation between normal, pre and malignant
endometrium.
The data and results collected were tabulated and statistically analyzed. During analyzing the statistical data