Abstract: Objective The aim of this study is to evaluate whether neutrophil-lymphocyte ratio(NLR)is associated with vulvar biopsy pathology,and to examine whether NLR can be used as an inflammatory marker to differentiate vulvar squamous cell carcinoma(VSCC)from its precancerous lesion vulvar intraepithelial neoplasia(VIN). Methods A retrospective study was performed on 386 patients undergoing vulvar biopsy from December 2012 to June 2020.The correlation between preoperative NLR and the biopsy pathologic findings were evaluated. Results The mean NLR of the patients with VSCC was significantly higher than that of the patients with VIN.The cut-off value of NLR in detecting VSCC from VIN selected on the ROC curve was 3.01 with 88.2% sensitivity and 67.8% specificity.Multivariate analysis identified an elevated NLR,age,and tumor size were associated with the presence of vulvar carcinoma and patients with elevated NLR have the highest risk of VSCC(OR=4.84,95% CI:4.17~7.14,P＜0.001). Conclusion NLR may be a useful marker to differentiate VSCC from VIN,and it may help in decision making(pre)cancerous pathologies of the vulvar.

Key words: Neutrophil-lymphocyte ratio;Prediction;Vulvar squamous cell carcinoma;Vulvar intraepithelial neoplasia