Prognostic Significance of Inflammatory Marker Combinations for Clinicopathological Features in Endometrial Cancer

Background The role of systemic inflammation in cancer prognosis has garnered increasing interest. The prognostic significance of novel inflammatory markers such as glucose to lymphocyte ratio (GLR) in endometrioid-type endometrial cancer (EC) and their relationship with clinicopathological parameters have not yet been fully elucidated. This study aimed to evaluate the association of preoperative inflammatory markers, particularly with lymphovascular space invasion (LVSI), and aggressive tumor characteristics, and to develop a model predicting LVSI presence. Methods Data from 156 patients who underwent surgical treatment for endometrioid-type EC were retrospectively analysed. Optimal threshold values for inflammatory markers such as GLR, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and Systemic Immune-Inflammation Index (SII) calculated from preoperative blood tests in predicting LVSI were determined using ROC analysis. Multivariate logistic regression analysis was used to identify independent risk factors, and a nomogram predicting LVSI was created. Results High PLR (OR: 3.70, p = 0.033) and high NLR (OR: 8.36, p = 0.044) values were identified as independent risk factors for LVSI. High GLR showed a strong trend towards an increased LVSI risk (OR: 4.49, p = 0.054). SII, which showed the strongest association with LVSI in univariate analysis (p = 0.004), could not be included in multivariate analysis due to statistical instability in the model. A nomogram based on PLR, NLR, and GLR was successfully developed to predict LVSI. Conclusions Preoperative inflammatory markers are valuable, low-cost, and easily accessible tools for predicting LVSI presence in endometrioid-type EC. The developed nomogram may assist clinicians in identifying high-risk patients and personalizing surgical strategy. Trial registration: Retrospectively registered. The study protocol was approved by the Clinical Research Ethics Committee of Mersin University Rectorate (No: 2024/52, Date: 03.06.2024).