To prevent further development of extramammary Paget's disease (EMPD), it is critical to detect lymph node metastasis at an early stage. Therefore, biomarkers that predict the risk of lymph node metastasis are required. In the present retrospective study, we evaluated the potential of neutrophil-to-lymphocyte ratio (NLR) in peripheral blood samples as a biomarker for the risk of lymph node metastasis in EMPD. This study involved 137 EMPD patients who underwent sentinel lymph node biopsy (SLNB) at our hospital from March 2003 to March 2020. The χ2 test, Mann-Whitney U test, logistic regression analysis and Kruskal-Wallis test were used to analyze the correlations between NLR and clinical features/laboratory findings and between SLNB positivity and clinical features/laboratory findings. Receiver-operator curves were constructed using the DeLong model to define the optimal NLR cutoff value. The NLR cutoff value was defined as 3.0. The high NLR group had 30 patients whose NLRs exceeded 3 (NLR > 3), and 23% of the patients showed sentinel lymph node metastasis (SLNM). The low NLR group had 107 patients whose NLRs were no more than 3 (NLR ≤ 3), and 8% of the patients had SLNM. The rate of SLNM was significantly higher in the high NLR group than in the low NLR group (χ2 test; P = .0245). The odds ratio of SLNM for patients with NLR greater than 3 was 3.311 (95% confidence interval [CI], 1.117 to 9.804; P = .0380) compared with patients with NLR of 3 or less. Then, we classified the patients into 2 groups by SLNB results. Sixteen of the 137 patients (11.7%) showed SLNM. In the logistic regression analysis of 5 variables in 137 patients (Table II) and six variables including carcinoembryonic antigen (CEA) in 55 patients for SLNB positivity, only NLR was found to be significantly associated with SLNB positivity. Here we reported NLR might be a significant predictor for LNM in EMPD patients, providing us with a clue for determining which of them could benefit from SLNB.

ESDR283 - Neutrophil/lymphocyte ratio as a predictor of lymph node metastasis in extramammary Paget disease: A retrospective study

50th Annual Meeting of the European Society for Dermatological Research. VIRTUAL MEETING