Association of Systemic Inflammatory Markers With Endometrioma Diagnosis and Douglas Involvement: A Retrospective Analysis

Background This study sought to examine the function of hematological inflammatory markers in differentiating endometrioma from other benign ovarian cysts prior to surgery and in individuals with Douglas involvement. Materials and Methods The study was designed retrospectively and included 480 patients (321 endometrioma, 153 non-endometrioma) who were operated on for benign ovarian cysts at Mersin University Hospital between January 1, 2004, and March 1, 2024. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), Pan-immune inflammation value (PIV), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were analyzed as hematological inflammatory markers. Additionally, the indices were evaluated in patients with Douglas involvement, and ROC analysis was conducted to determine their predictive power. Results The average age of patients with endometrioma did not show a significant difference compared to the average of patients with other benign ovarian cysts (39.0 vs. 40.0 years, p = 0.174). NLR, PLR, SII, and SIRI were significantly higher in the endometrioma group (p < 0.001). SIRI had the highest value (0.894) in distinguishing endometrioma from other benign ovarian cysts. Douglas involvement was found to be significantly high with SII, PIV, and PLR having AUCs of 0.569, 0.576, and 0.0582, respectively. Conclusion Hematological inflammatory markers, particularly SIRI, were found to be useful in distinguishing endometriomas from other benign ovarian cysts, and PLR was identified as a potential non-invasive biomarker when analyzing its predictive power in patients with Douglas involvement.