Diagnostic Performance of Serum Inflammatory Biomarkers in the Preoperative Differentiation of Uterine Myoma, Adenomyosis and Malignant Uterine Tumors: A Retrospective Study

Aslı Akdöner, Kadir Alper Mankan, Elif Şeyma Çetinkaya, Onur Yavuz, Zeynep Bayramoğlu, Sefa Kurt
In: Medicina · 2026 · vol. 62(11) , pp. 2205 · doi:10.3390/medicina62112205 · W7225775953
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Abstract

Background and Objectives: Preoperative differentiation of uterine myoma, adenomyosis, and malignant uterine tumors is crucial for assessing the patient’s desire for fertility, presenting possible medical options, planning the surgical method, preparing for surgery, and, in the presence of malignancy, reducing the risk of metastasis and secondary surgery. Our aim is to evaluate the effectiveness of serum inflammatory markers in the preoperative differential diagnosis of these diseases. Materials and Methods: This study was conducted retrospectively. Female patients aged 18 years and older who were diagnosed with adenomyosis, uterine myoma, and malignant uterine tumors comprising uterine sarcomas and carcinosarcomas were included in the study. The patients’ characteristics, clinical and laboratory information were recorded from their files. IBM SPSS version 24.0 was used for analysis. Results: When cases were compared in terms of type of surgery, neutrophil count, SII, and NLR levels, significant differences were found among all cases (all p < 0.001). In adenomyosis cases, MCV (p = 0.01), MCH (p = 0.02), SIRI (p < 0.001), PIV (p = 0.001), and PLR (p = 0.004) levels were significantly higher, while RDW (p = 0.004) and PCT (p = 0.02) levels were lower compared to the uterine myoma group. In adenomyosis cases, WBC (p < 0.001) and MPV (p = 0.003) levels were found to be significantly higher compared to other groups, while Plt (p < 0.001), eosinophil (p < 0.001), lymphocyte (p < 0.001), and monocyte (p < 0.001) levels were significantly lower. Separate ROC analyses were performed for the malignant uterine tumor group and adenomyosis. In the ROC analysis comparing the malignant group with benign uterine diseases, all inflammatory biomarkers demonstrated poor diagnostic performance, with AUC values ranging from 0.489 to 0.538. In contrast, in the ROC analysis for adenomyosis, inflammatory biomarkers demonstrated moderate diagnostic performance, with NLR showing the highest diagnostic accuracy (AUC:0.820, 95% CI:0.763–0.878), followed by SII (AUC:0.767, 95% CI:0.704–0.830) and WBC (AUC:0.750, 95% CI:0.683–0.817) (all p ≤ 0.001). Conclusions: In conclusion, the use of serum inflammatory markers alone for preoperative diagnosis is not recommended.

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