Systemic Inflammatory Response Markers Associated with Infertility and Endometrioma or Uterine Leiomyoma in Endometriosis

X Jing, L. Chang, Jingxian Sun, Jing Peng, Dou Yu, Xijin Xu, Chi Ma, Dong Z, Dong Zhao, Yanhong Liu, Qin Shao, Heng Zhang, Lijing Wang, Yong Zhang, Xun Qu
In: Therapeutics and Clinical Risk Management, Vol Volume 16, Pp 403-412 (2020) · 2020 · W4391526745
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Lower neutrophil-to-lymphocyte ratio (NLR) is a risk factor for infertility in endometriosis, and NLR combined with CA125 can help diagnose endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text ⓘ

This study evaluated systemic inflammatory response markers—preoperative white blood cell subtypes, neutrophil:lymphocyte ratio (NLR), platelet:lymphocyte ratio (PLR), monocyte:lymphocyte ratio (MLR)—and CA125 in 662 women with laparoscopically confirmed, pathologically confirmed endometriosis, compared with 83 patients with pathologically confirmed benign ovarian tumors. Using logistic regression and receiver operating characteristic analyses, the authors found that lower NLR was an independent risk factor for endometriosis-related infertility, while lymphocyte levels were higher and CA125, NLR, MLR, and PLR were elevated in endometriosis overall; combining NLR with CA125 improved sensitivity for distinguishing endometriosis from benign ovarian tumors. They also reported positive correlations of CA125 and NLR with disease stage, oviduct adhesion, and ovarian ectopic cyst diameter, with the main caveat being that the study population was selected from patients undergoing laparoscopic surgery and thus may not generalize beyond this clinical context. This paper is centrally about endometriosis — it links systemic inflammatory markers (especially NLR) and CA125 to endometriosis-related infertility and endometrioma characteristics.

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Abstract

Xuanxuan Jing,1,* Chen Li,1,2,* Jintang Sun,1 Jin Peng,3 Yu Dou,4 Xiaofei Xu,3 Chao Ma,1 Zhaogang Dong,5 Yanguo Liu,6 Hui Zhang,3 Qianqian Shao,1 Hui Zhang,7 Lijie Wang,3 Yun Zhang,1 Xun Qu1 1Institute of Basic Medical Sciences, Key Laboratory of Cardiovascular Remodeling and Function Research, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic China; 2Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, People’s Republic of China; 3Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic of China; 4Department of Stomatology and Institute of Stomatology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic China; 5Department of Clinical Laboratory, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic China; 6Department of Medical Oncology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic of China; 7Department of Pathology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xun Qu; Lijie Wang Email [email protected]; [email protected]: The aim of this study was to find the most useful marker of endometriosis-related infertility and evaluate predictive and diagnostic values of systemic inflammatory response markers (preoperative white blood–cell subtypes, neutrophil:lymphocyte ratio [NLR], platelet:lymphocyte ratio [PLR], and monocyte:lymphocyte ratio [MLR]) and CA125 levels in endometriosis patients.Methods: This study comprised 662 women who had undergone laparoscopic surgery and been pathologically confirmed as having endometriosis and 83 patients pathologically confirmed with benign ovarian tumors. Related inflammatory factors in endometriosis complicated by infertility were analyzed via logistic regression analysis. Diagnostic values of the inflammatory response markers were obtained by receiver operating–characteristic analysis.Results: We firstly identified that lower NLR level was an independent risk factor of infertility. Serum lymphocytes were significantly higher in endometriosis patients, while serum CA125, NLR, MLR, and PLR were elevated. For differentiating endometriosis from other benign ovarian tumors, the combination of NLR and CA125 achieved greater sensitivity than CA125 alone. In addition, both CA125 and NLR were positively correlated with stage, oviduct adhesion, and diameter of ovarian ectopic cysts.Conclusion: NLR may be used as a simple and easily obtained predictive marker for endometriosis with infertility. Moreover, NLR can be a neoadjuvant biomarker for serum CA125 to diagnose endometriosis.Keywords: endometriosis, endometrioma, uterine leiomyoma, infertility, NLR, PLR, CA125
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Therapeutics and Clinical Risk Management (May 2020) Systemic Inflammatory Response Markers Associated with Infertility and Endometrioma or Uterine Leiomyoma in Endometriosis Abstract Xuanxuan Jing,1,* Chen Li,1,2,* Jintang Sun,1 Jin Peng,3 Yu Dou,4 Xiaofei Xu,3 Chao Ma,1 Zhaogang Dong,5 Yanguo Liu,6 Hui Zhang,3 Qianqian Shao,1 Hui Zhang,7 Lijie Wang,3 Yun Zhang,1 Xun Qu1 1Institute of Basic Medical Sciences, Key Laboratory of Cardiovascular Remodeling and Function Research, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic China; 2Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, People’s Republic of China; 3Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic of China; 4Department of Stomatology and Institute of Stomatology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic China; 5Department of Clinical Laboratory, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic China; 6Department of Medical Oncology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic of China; 7Department of Pathology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xun Qu; Lijie Wang Email [email protected]; [email protected]: The aim of this study was to find the most useful marker of endometriosis-related infertility and evaluate predictive and diagnostic values of systemic inflammatory response markers (preoperative white blood–cell subtypes, neutrophil:lymphocyte ratio [NLR], platelet:lymphocyte ratio [PLR], and monocyte:lymphocyte ratio [MLR]) and CA125 levels in endometriosis patients.Methods: This study comprised 662 women who had undergone laparoscopic surgery and been pathologically confirmed as having endometriosis and 83 patients pathologically confirmed with benign ovarian tumors. Related inflammatory factors in endometriosis complicated by infertility were analyzed via logistic regression analysis. Diagnostic values of the inflammatory response markers were obtained by receiver operating–characteristic analysis.Results: We firstly identified that lower NLR level was an independent risk factor of infertility. Serum lymphocytes were significantly higher in endometriosis patients, while serum CA125, NLR, MLR, and PLR were elevated. For differentiating endometriosis from other benign ovarian tumors, the combination of NLR and CA125 achieved greater sensitivity than CA125 alone. In addition, both CA125 and NLR were positively correlated with stage, oviduct adhesion, and diameter of ovarian ectopic cysts.Conclusion: NLR may be used as a simple and easily obtained predictive marker for endometriosis with infertility. Moreover, NLR can be a neoadjuvant biomarker for serum CA125 to diagnose endometriosis.Keywords: endometriosis, endometrioma, uterine leiomyoma, infertility, NLR, PLR, CA125

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