Dynamic Changes in Systemic Inflammatory Indices Predict Residual High-Grade Lesions After Margin-Positive Cervical...

Area of Science:

• Oncology
• Immunology
• Biomarkers

Background:

• Cervical cancer is a significant global health issue.
• Loop electrosurgical excision procedure (LEEP) treats cervical intraepithelial neoplasia, but positive margins necessitate further management.
• Current post-LEEP surveillance relies on HPV testing, which has limitations in specificity, highlighting the need for additional biomarkers.

Purpose of the Study:

• To investigate if changes in systemic inflammatory indices predict residual high-grade lesions after incomplete LEEP.
• To evaluate the predictive value of dynamic changes in platelet-to-lymphocyte ratio (PLR), systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII).

Main Methods:

• A multicenter retrospective study of 125 patients undergoing repeat surgery after LEEP due to positive margins.
• Analysis of preoperative inflammatory index changes (ΔPLR, ΔSIRI, ΔSII) between the first and second procedures.
• Comparison of index changes with histopathological findings of the second surgery using Mann-Whitney U test and ROC analysis.

Main Results:

• Significant differences in ΔPLR (p=0.032) and ΔSII (p=0.048) were observed between patients with and without residual high-grade lesions or invasive cancer.
• ΔSIRI showed borderline significance (p=0.050), but was significantly associated with invasive cancer (p=0.035).
• Receiver operating characteristic (ROC) analysis indicated modest predictive performance (AUC ≈ 0.60).

Conclusions:

• Dynamic changes in PLR, SIRI, and SII show potential as inexpensive adjunct biomarkers for risk stratification after incomplete LEEP.
• These inflammatory indices can complement HPV testing in specific clinical scenarios for improved post-treatment surveillance.
• Further research may validate these markers for routine clinical use in managing cervical abnormalities.