Retrospective study of inflammatory markers in high-grade cervical lesions

The aim of this study was to evaluate the predictive value of systemic inflammation markers for abnormal cervical screening results and high-grade cervical lesions in women participating in a human papillomavirus- and cytology-based screening program, thereby determining colposcopy indications more accurately to reduce unnecessary colposcopy requests and prevent overtreatment.

A total of 2,758 women who underwent cervical cancer screening between 2020 and 2025 were included in this retrospective cross-sectional study. Abnormal screening results were defined as abnormal cytology (≥Atypical squamous cells of undetermined significance [ASC-US]) and/or high-risk human papillomavirus positivity. Hematological parameters measured within 1 month prior to screening were used to calculate neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index. Continuous variables were evaluated using nonparametric tests, and the independent predictors of abnormal screening results and high-grade lesions were identified using logistic regression models.

Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index values were significantly higher in the abnormal smear groups and in human papillomavirus -positive patients (all p<0.001). Neutrophil-to-lymphocyte ratio displayed the highest diagnostic performance for high-grade lesions (area under the curve=0.871; cutoff value >4.41, sensitivity 66.7%, specificity 99.2%), followed by systemic immune-inflammation index (area under the curve=0.847), while platelet-to-lymphocyte ratio showed lower specificity (area under the curve=0.741).

In conclusion, our findings suggest that inflammatory markers are associated with abnormal cervical screening results. To determine the significance and clinical utility of serum inflammatory markers, multicenter clinical trials involving larger patient cohorts are needed.