Significance of the neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, and platelet-lymphocyte ratio in peripheral blood for endometrial cancer

Objective: To evaluate the diagnostic value of the expression of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in distinguishing endometrial cancer from benign uterine lesions. Methods: In this retrospective analysis, clinical data were collected from 112 patients treated at Hengshui People's Hospital (Harrison International Peace Hospital) between January 2022 and December 2023. The cohort comprised 56 patients diagnosed with endometrial cancer and 56 patients with benign uterine lesions, matched 1:1. Demographic details, comorbidities, and serological parameters - including WBC, RBC, Hb, MPV, neutrophil, lymphocyte, monocyte, and platelet counts - were recorded. NLR, LMR, and PLR values were subsequently calculated. Results: Significant serological differences were observed between the endometrial cancer and benign lesion groups, including NLR (4.25 +/- 1.23 vs. 2.18 +/- 0.95, P < 0.001), LMR (3.12 +/- 0.98 vs. 5.08 +/- 1.75, P < 0.001), and PLR (201.23 +/- 45.66 vs. 150.27 +/- 30.45, P < 0.001). Correlation analysis indicated a strong association between endometrial cancer and NLR (r = 0.689, P < 0.001), LMR (r = -0.572, P < 0.001), and PLR (r = 0.552, P < 0.001). ROC analysis demonstrated that NLR (AUC = 0.91) offered superior diagnostic value relative to LMR (AUC = 0.841) and PLR (AUC = 0.83). Logistic regression identified significant associations for NLR >= 3.4 (OR = 69.173, P < 0.001), LMR >= 4.055 (OR = 0.048, P < 0.001), and PLR >= 150.445 (OR = 18.134, P = 0.002). DeLong's test revealed no significant differences in diagnostic performance among the ratios (NLR vs. LMR, P = 0.149; NLR vs. PLR, P = 0.08; LMR vs. PLR, P = 0.842). Conclusion: NLR, LMR, and PLR are valuable hematological markers for diagnosing endometrial cancer, with NLR demonstrating the highest sensitivity and specificity. These findings support the inclusion of these serological parameters in routine diagnostic protocols to enhance the accurate identification of endometrial cancer.