{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:11:23Z","timestamp":1789049483030,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>(1) Background\/Objective: Routine blood tests may provide useful information at different stages of epithelial ovarian cancer (EOC) management. This study evaluated continuous lactate dehydrogenase (LDH), carbohydrate antigen 125 (CA125), and neutrophil-to-lymphocyte ratio (NLR) values for diagnostic discrimination in epithelial ovarian cancer (EOC) and, separately, triple-positive status in relation to platinum resistance and survival. (2) Methods: This retrospective study included 238 patients with EOC and 238 individually matched patients with benign ovarian lesions. Continuous biomarkers were entered into logistic regression models for diagnosis. Triple-positive status was defined as LDH &gt; 195.5 U\/L, CA125 &gt; 35.37 U\/mL, and NLR &gt; 2.63. Logistic regression was used for platinum resistance and Cox regression for progression-free survival (PFS) and overall survival (OS). Bootstrap internal validation was performed for the diagnostic models and PFS nomogram. (3) Results: The continuous LDH + CA125 + NLR model yielded an AUC of 0.873, with 75.97% sensitivity and 88.66% specificity; AUCs were 0.751 in early-stage and 0.958 in advanced-stage EOC. Adding NLR to LDH + CA125 did not significantly improve the AUC overall or within stage groups. Triple-positive status was associated with platinum resistance (adjusted OR = 3.488, 95% CI 1.504\u20138.087; p = 0.004), shorter PFS (adjusted HR = 3.109, 95% CI 1.772\u20135.456; p &lt; 0.001), and shorter OS in advanced-stage EOC (adjusted HR = 3.538, 95% CI 1.385\u20139.038; p = 0.008). The PFS nomogram had a bootstrap-corrected C-index of 0.7521. (4) Conclusions: The continuous three-marker model showed diagnostic discrimination in this selected surgical cohort, while triple-positive status was associated with platinum resistance and adverse survival outcomes. External validation is needed.<\/jats:p>","DOI":"10.3390\/curroncol33090551","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:04:57Z","timestamp":1789045497000},"page":"551","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Value of an LDH\u2013CA125\u2013NLR Panel for Diagnosis, Platinum Resistance, and Prognostic Assessment in Epithelial Ovarian Cancer"],"prefix":"10.3390","volume":"33","author":[{"given":"Shuiqing","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Jinzhen","family":"Guo","sequence":"additional","affiliation":[{"name":"Chinese Institutes for Medical Research, Capital Medical University, Beijing 100069, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Ziyi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Yan","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Yingying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1172-6750","authenticated-orcid":false,"given":"Hua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1038\/s41571-024-00881-3","article-title":"Global epidemiology of epithelial ovarian cancer","volume":"21","author":"Webb","year":"2024","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2182","DOI":"10.1016\/S0140-6736(21)00731-5","article-title":"Ovarian cancer population screening and mortality after long-term follow-up in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): A randomised controlled trial","volume":"397","author":"Menon","year":"2021","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"188503","DOI":"10.1016\/j.bbcan.2021.188503","article-title":"Roles of CA125 in diagnosis, prediction, and oncogenesis of ovarian cancer","volume":"1875","author":"Zhang","year":"2021","journal-title":"Biochim. Biophys. Acta Rev. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.annonc.2023.07.011","article-title":"Newly diagnosed and relapsed epithelial ovarian cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"34","author":"Harter","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"972","DOI":"10.6004\/jnccn.2022.0047","article-title":"NCCN Guidelines\u00ae Insights: Ovarian Cancer, Version 3.2022","volume":"20","author":"Armstrong","year":"2022","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1038\/s41571-022-00686-2","article-title":"The multiple roles of LDH in cancer","volume":"19","author":"Claps","year":"2022","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1038\/s41577-020-0406-2","article-title":"Lactate modulation of immune responses in inflammatory versus tumour microenvironments","volume":"21","author":"Certo","year":"2021","journal-title":"Nat. Rev. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"103627","DOI":"10.1016\/j.ebiom.2021.103627","article-title":"Lactate in the tumour microenvironment: From immune modulation to therapy","volume":"73","author":"Wang","year":"2021","journal-title":"EBioMedicine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"709","DOI":"10.5468\/ogs.20117","article-title":"Serum lactate dehydrogenase is a possible predictor of platinum resistance in ovarian cancer","volume":"63","author":"Ikeda","year":"2020","journal-title":"Obstet. Gynecol. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1038\/s41577-021-00571-6","article-title":"Neutrophils in cancer: Heterogeneous and multifaceted","volume":"22","author":"Hedrick","year":"2022","journal-title":"Nat. Rev. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e20220011","DOI":"10.1084\/jem.20220011","article-title":"Neutrophil phenotypes and functions in cancer: A consensus statement","volume":"219","author":"Quail","year":"2022","journal-title":"J. Exp. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s13048-021-00902-0","article-title":"Neutrophil-to-lymphocyte ratio and chemotherapy response score as prognostic markers in ovarian cancer patients treated with neoadjuvant chemotherapy","volume":"14","author":"Liontos","year":"2021","journal-title":"J. Ovarian Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Cupp, M.A., Cariolou, M., Tzoulaki, I., Aune, D., Evangelou, E., and Berlanga-Taylor, A.J. (2020). Neutrophil to lymphocyte ratio and cancer prognosis: An umbrella review of systematic reviews and meta-analyses of observational studies. BMC Med., 18.","DOI":"10.1186\/s12916-020-01817-1"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"105554","DOI":"10.1016\/j.ebiom.2024.105554","article-title":"Estimating the ovarian cancer CA-125 preclinical detectable phase, in-vivo tumour doubling time, and window for detection in early stage: An exploratory analysis of UKCTOCS","volume":"112","author":"Bedia","year":"2025","journal-title":"EBioMedicine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1136\/ijgc-2021-002565","article-title":"ESGO\/ISUOG\/IOTA\/ESGE Consensus Statement on pre-operative diagnosis of ovarian tumors","volume":"31","author":"Timmerman","year":"2021","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1111\/aogs.14224","article-title":"The diagnostic accuracy of human epididymis protein 4 (HE4) for discriminating between benign and malignant pelvic masses: A systematic review and meta-analysis","volume":"100","author":"Olsen","year":"2021","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"17308","DOI":"10.1038\/s41598-021-96552-9","article-title":"Diagnostic measures comparison for ovarian malignancy risk in epithelial ovarian cancer patients: A meta-analysis","volume":"11","author":"Suri","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Spagnol, G., Marchetti, M., Carollo, M., Bigardi, S., Tripepi, M., Facchetti, E., De Tommasi, O., Vitagliano, A., Cavallin, F., and Tozzi, R. (2024). Clinical Utility and Diagnostic Accuracy of ROMA, RMI, ADNEX, HE4, and CA125 in the Prediction of Malignancy in Adnexal Masses. Cancers, 16.","DOI":"10.3390\/cancers16223790"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"104434","DOI":"10.1016\/j.critrevonc.2024.104434","article-title":"Clinical and molecular features of platinum resistance in ovarian cancer","volume":"201","author":"Miras","year":"2024","journal-title":"Crit. Rev. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s12943-024-01967-3","article-title":"Drug resistance in ovarian cancer: From mechanism to clinical trial","volume":"23","author":"Wang","year":"2024","journal-title":"Mol. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1200\/JCO.23.01771","article-title":"Treatment approaches for platinum-resistant ovarian cancer","volume":"42","author":"Liu","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4554","DOI":"10.1038\/s41467-022-32101-w","article-title":"Metabolic reprogramming from glycolysis to fatty acid uptake and beta-oxidation in platinum-resistant cancer cells","volume":"13","author":"Tan","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_24","first-page":"761","article-title":"New horizons for platinum-resistant ovarian cancer: Insights from the 2023 American society of clinical oncology (ASCO) and european society for medical oncology (ESMO) annual meetings","volume":"34","author":"Madariaga","year":"2024","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1080\/14728222.2023.2248376","article-title":"Update value and clinical application of MUC16 (cancer antigen 125)","volume":"27","author":"Song","year":"2023","journal-title":"Expert Opin. Ther. Targets"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1186\/s13048-023-01207-0","article-title":"MUC16 stimulates neutrophils to an inflammatory and immunosuppressive phenotype in ovarian cancer","volume":"16","author":"Wu","year":"2023","journal-title":"J. Ovarian Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.ygyno.2018.12.023","article-title":"MUC16 suppresses human and murine innate immune responses","volume":"152","author":"Felder","year":"2019","journal-title":"Gynecol. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1038\/s43018-023-00599-8","article-title":"Single-cell analyses implicate ascites in remodeling the ecosystems of primary and metastatic tumors in ovarian cancer","volume":"4","author":"Zheng","year":"2023","journal-title":"Nat. Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1186\/s12943-025-02438-z","article-title":"Harnessing ovarian cancer ascites for translational science: Models, biomarkers, and therapeutics","volume":"24","author":"Dogra","year":"2025","journal-title":"Mol. Cancer"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"101083","DOI":"10.1016\/j.gore.2022.101083","article-title":"Early-Stage epithelial ovarian cancer: Predictors of survival","volume":"44","author":"Upadhyay","year":"2022","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"102074","DOI":"10.1016\/j.canep.2021.102074","article-title":"Ovarian cancer survival by stage, histotype, and pre-diagnostic lifestyle factors, in the prospective UK Million Women Study","volume":"76","author":"Gaitskell","year":"2022","journal-title":"Cancer Epidemiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"6540","DOI":"10.1038\/s41598-021-86122-4","article-title":"Development and validation for prognostic nomogram of epithelial ovarian cancer recurrence based on circulating tumor cells and epithelial-mesenchymal transition","volume":"11","author":"Yang","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"11385","DOI":"10.1002\/cam4.5853","article-title":"Development and external validation of nomograms for predicting individual survival in patients with ovarian clear cell carcinoma","volume":"12","author":"Liu","year":"2023","journal-title":"Cancer Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e074819","DOI":"10.1136\/bmj-2023-074819","article-title":"Evaluation of clinical prediction models (part 1): From development to external validation","volume":"384","author":"Collins","year":"2024","journal-title":"BMJ"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e078378","DOI":"10.1136\/bmj-2023-078378","article-title":"TRIPOD+AI statement: Updated guidance for reporting clinical prediction models that use regression or machine learning methods","volume":"385","author":"Collins","year":"2024","journal-title":"BMJ"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1200\/JCO.22.01549","article-title":"Overall survival with maintenance olaparib at a 7-year follow-up in patients with newly diagnosed advanced ovarian cancer and a BRCA mutation: The SOLO1\/GOG 3004 trial","volume":"41","author":"DiSilvestro","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.1056\/NEJMoa1911361","article-title":"Olaparib plus Bevacizumab as First-Line Maintenance in Ovarian Cancer","volume":"381","author":"Pautier","year":"2019","journal-title":"N. Engl. J. Med."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/9\/551\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:25:25Z","timestamp":1789046725000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/9\/551"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":37,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["curroncol33090551"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33090551","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]}}}