Potential Efficacy of Inflammatory Response Markers for the Detection of Ovarian Cancer in Patients with Endometrioma

Yuki Iida, Iida Y, Sato S, Shinya Sato, Koji Yamamoto, Yamamoto K, Okawa M, Masayo Okawa, Hikino K, Kohei Hikino, Mayumi Sawada, Sawada M, Komatsu H, Hiroaki Komatsu, Fuminori Taniguchi, Taniguchi F
Yonago acta medica · 2025 · vol. 68(1) , pp. 51–57 · doi:10.33160/yam.2025.02.006 · PMID:39968114 · PMC11831038 · W4406721830
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-06 ⓘ

This study found that preoperative inflammatory markers, particularly NLR and SII, may help distinguish stage I ovarian cancer from endometrioma, with combined markers potentially increasing diagnostic accuracy.

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

This retrospective study compared preoperative inflammatory response markers and tumor markers in patients undergoing surgery between 2010 and 2021, including stage I ovarian cancer with clear cell carcinoma or endometrioid carcinoma histology and patients with ovarian endometrioma. White blood cell count, CRP, ESR, fibrinogen, D-dimer, NLR, PLR, and SII were analyzed alongside CA125 and CA19-9, and median marker values and receiver operating characteristic AUCs were compared between groups. Inflammatory response markers were significantly higher in the CCC/EC group than in the endometrioma group, and AUCs for CRP, ESR, D-dimer, NLR, and SII were reported as significantly higher than those of CA125 and CA19-9, with some ovarian cancer cases having NLR/PLR/SII above cut-offs. The paper’s caveat is that it uses a surgical, single-institution stage I cohort. Relevance to endometriosis: this paper focuses on distinguishing ovarian clear cell/endometrioid carcinoma from ovarian endometrioma, which is an endometriosis manifestation.

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Abstract

BACKGROUND: This study evaluated the effectiveness of preoperative inflammatory response markers in distinguishing clear cell carcinoma (CCC) and endometrioid carcinoma (EC) from ovarian endometrioma. METHODS: Patients with stage I ovarian cancer with histology CCC/EC or endometrioma who underwent surgery at our institution between 2010 and 2021 were included. Preoperative inflammatory response markers evaluated were white blood cell count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, D-dimer, neutrophil/lymphocyte ratio (NLR), platelet count/lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). The tumor markers CA125 and CA19-9 were analyzed. The median values of these markers were compared between the CCC/EC and the endometrioma groups. The areas under the curve (AUC) in Receiver Operating Characteristic analysis were compared. RESULTS: Fifty patients with stage I CCC/EC and 247 patients with endometrioma were included in the study. Inflammatory response markers were significantly higher in CCC/EC cases than in endometrioma cases (P < 0.01). Tumor markers demonstrated higher specificity than inflammatory response markers. The AUCs of CRP, ESR, D-dimer, NLR, and SII were significantly higher than those of CA125 and CA19-9 (P < 0.01). The values of NLR, PLR, and SII in four cases of ovarian cancer with preoperative suspected endometrioma were higher than the cut-off value. CONCLUSION: Inflammatory response markers may be useful for the detection of stage I ovarian cancer. Notably, the NLR or SII, calculated using a complete blood count, appears particularly efficient. Combining tumor and inflammatory response markers may enhance diagnostic accuracy in distinguishing ovarian cancer from endometrioma.
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Keywords

inflammatory response marker, neutrophil-to-lymphocyte ratio (NLR), ovarian endometrioma, systemic immune-inflammation index (SII), tumor marker 2025 Volume 68 Issue 1 Pages 51-57 Details

Abstract

Background This study evaluated the effectiveness of preoperative inflammatory response markers in distinguishing clear cell carcinoma (CCC) and endometrioid carcinoma (EC) from ovarian endometrioma.

Methods

Patients with stage I ovarian cancer with histology CCC/EC or endometrioma who underwent surgery at our institution between 2010 and 2021 were included. Preoperative inflammatory response markers evaluated were white blood cell count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, D-dimer, neutrophil/lymphocyte ratio (NLR), platelet count/lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). The tumor markers CA125 and CA19-9 were analyzed. The median values of these markers were compared between the CCC/EC and the endometrioma groups. The areas under the curve (AUC) in Receiver Operating Characteristic analysis were compared.

Results

Fifty patients with stage I CCC/EC and 247 patients with endometrioma were included in the study. Inflammatory response markers were significantly higher in CCC/EC cases than in endometrioma cases (P < 0.01). Tumor markers demonstrated higher specificity than inflammatory response markers. The AUCs of CRP, ESR, D-dimer, NLR, and SII were significantly higher than those of CA125 and CA19-9 (P < 0.01). The values of NLR, PLR, and SII in four cases of ovarian cancer with preoperative suspected endometrioma were higher than the cut-off value.

Conclusion

Inflammatory response markers may be useful for the detection of stage I ovarian cancer. Notably, the NLR or SII, calculated using a complete blood count, appears particularly efficient. Combining tumor and inflammatory response markers may enhance diagnostic accuracy in distinguishing ovarian cancer from endometrioma. © 2025 Tottori University Medical Press Favorites & Alerts Recently viewed articles

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Condition tags

endometrioma

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (18)

SciLite annotations

chemicals 4
d-cellohexaose jasplakinolide d glycolaldehyde dimer d-cellohexaose
organisms 1
human

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