Prognostic Inflammatory Biomarkers in Gynecologic Oncology
Summary
The identification of prognostic biomarkers that capture the interplay between tumour biology and host inflammatory response has become a central priority in the management of gynaecologic malignancies. Systemic inflammatory indices, derived from routine blood counts and acute-phase proteins, offer a cost-effective window into the tumour-immune microenvironment. Ratios such as neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR) and lymphocyte-to-monocyte (LMR), alongside composite measures such as the systemic immune-inflammation index (SII), correlate with disease stage, treatment response and survival across ovarian, endometrial and cervical cancers. These indices reflect processes of immune suppression, angiogenesis and metastatic potential driven by myeloid cell expansion and cytokine release. Their incorporation into prognostic models holds promise for personalised surgical planning, adjuvant therapy selection and surveillance strategies on a global scale.
Research from Nature Portfolio
Recent studies have demonstrated the clinical value of combining inflammatory and tumour biomarkers into predictive tools for gynaecologic oncology. One 2024 investigation developed a nomogram integrating pretreatment NLR, PLR, LMR and CA-125 levels in a cohort of over 200 ovarian tumour patients. Elevated NLR and PLR and reduced LMR were significantly associated with malignancy versus benign histology. Multivariable analysis identified PLR and CA-125 as independent predictors of malignant status. The resulting nomogram improved diagnostic precision and offers a pragmatic approach to preoperative risk stratification, emphasising the utility of merging systemic inflammation indices with established serum markers.
Prognostic Inflammatory Biomarkers in Gynecologic Oncology publication trend
The graph below shows the total number of articles in prognostic inflammatory biomarkers in gynecologic oncology across all publications each year (not limited to Nature Index journals).
Technical terms
Neutrophil-to-lymphocyte ratio (NLR): The quotient of circulating neutrophil count divided by lymphocyte count, serving as a surrogate for systemic inflammation and immune balance.
Platelet-to-lymphocyte ratio (PLR): The ratio of platelet count to lymphocyte count, reflecting thrombo-inflammatory activity and tumour–host interactions.
Lymphocyte-to-monocyte ratio (LMR): The proportion of lymphocytes relative to monocytes, indicative of adaptive immunity versus monocyte-driven inflammation.
Systemic immune-inflammation index (SII): A composite index calculated from neutrophils, platelets and lymphocytes, integrating multiple arms of the inflammatory response.
Cancer antigen 125 (CA-125): A glycoprotein shed by epithelial ovarian tumours, widely used in diagnosis and monitoring of disease burden.
Nomogram: A graphical predictive tool combining multiple variables to estimate individual risk or prognosis in clinical practice.
References
- The preoperative platelet to neutrophil ratio and lymphocyte to monocyte ratio are superior prognostic indicators compared with other inflammatory biomarkers in ovarian cancer. Frontiers in Immunology (2023).
- Prognostic Role of Neutrophil, Monocyte and Platelet to Lymphocyte Ratios in Advanced Ovarian Cancer According to the Time of Debulking Surgery. International Journal of Molecular Sciences (2023).
- Independent predictive value of blood inflammatory composite markers in ovarian cancer: recent clinical evidence and perspective focusing on NLR and PLR. Journal of Ovarian Research (2023).
- Nomogram development for predicting ovarian tumor malignancy using inflammatory biomarker and CA-125. Scientific Reports (2024).
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