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Novel inflammatory indices compared with CRP for diagnosing pelvic inflammatory disease: a case-control study
Jingwen Kong1, Jingjing Zhao1, Xiaohui Sun1
1Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, China.
BMC Women'S Health
|July 10, 2026
Summary
New blood count markers, Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI), show higher accuracy for diagnosing Pelvic Inflammatory Disease (PID) than C-reactive protein (CRP). These routine tests offer a promising, accessible tool for timely PID diagnosis.
Area of Science:
- Hematology and Immunology
- Gynecologic Infectious Diseases
- Diagnostic Biomarkers
Background:
- Pelvic Inflammatory Disease (PID) is a common infection with significant long-term complications.
- Clinical diagnosis of PID is challenging due to non-specific symptoms, necessitating improved diagnostic markers.
- Current biomarkers like C-reactive protein (CRP) have limited specificity for PID.
Purpose of the Study:
- To evaluate the diagnostic performance of novel complete blood count (CBC)-derived inflammatory indices for PID.
- To compare the accuracy of these indices against CRP in differentiating PID from non-inflammatory gynecological conditions.
- To explore the association between CBC-derived indices and ultrasound findings in PID patients.
Main Methods:
- A retrospective case-control study involving 135 PID patients and 135 age-matched controls.
- Calculation of inflammatory indices: Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), and Platelet-to-Lymphocyte Ratio (PLR) from routine CBCs.
- Diagnostic accuracy assessed using Receiver Operating Characteristic (ROC) curve analysis and multivariable logistic regression.
Main Results:
- All novel inflammatory indices were significantly elevated in PID patients compared to controls (p < 0.001).
- SII (AUC=0.870) and SIRI (AUC=0.832) demonstrated superior diagnostic accuracy for PID compared to CRP (AUC=0.648).
- SII, SIRI, NLR, MLR, and PLR were independent predictors of PID in multivariable analyses (p < 0.01).
Conclusions:
- CBC-derived indices SII and SIRI offer higher diagnostic accuracy for PID than CRP.
- These inexpensive and routinely available markers are promising for improving timely and accurate PID diagnosis.
- Preliminary findings suggest a correlation between inflammatory indices and specific ultrasound phenotypes, warranting further investigation.
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