Preoperative hematological parameters do not predict lesion severity or recurrence in cervical intraepithelial
Neçirvan Çağdaş Çaltek1, Mahmut Yassa2, Ayşe Bacaksız2
1Gynecologic Oncology Clinic, Basakşehir Cam and Sakura City Hospital, Istanbul, Turkey. nccaltek@gmail.com.
Objective:
To evaluate the predictive value of preoperative hematological parameters for determining lesion grade and recurrence risk in patients diagnosed with cervical intraepithelial neoplasia (CIN) by biopsy.
Materials And Methods:
This retrospective study included 700 women who underwent a loop electrosurgical excision procedure (LEEP) following colposcopy at a tertiary referral center. Preoperative complete blood counts obtained within one week before surgery were used to calculate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). These indices were compared according to LEEP histopathology and evaluated for recurrence over a two-year follow-up period.
Results:
No significant differences were observed in hematologic parameters (NLR, PLR, MLR, SII, SIRI) between low- and high-grade lesions (all p > 0.05). Similarly, among patients with biopsy-proven CIN2, preoperative indices did not differ across final LEEP results. During a 24-month follow-up, histologic recurrence occurred in 6.7% of patients. Recurrence was associated with HPV persistence (p < 0.001), whereas the univariable association with lower MLR values (p = 0.049) did not remain significant after multivariable adjustment. In multivariable analysis, only persistent HPV infection remained an independent predictor of recurrence (OR = 2.98, p = 0.014). ROC analysis showed weak and clinically limited discriminative power for MLR (AUC = 0.61).
Conclusion:
Preoperative hematologic parameters showed no clinically meaningful predictive value for lesion severity or recurrence and should not be used for clinical risk stratification.
