Tóth Zsófia, Lőczi Lotti, Sebők Barbara, Merkely Petra, Keszthelyi Emese, Lintner Balázs, Ács Nándor, Keszthelyi Attila, Várbíró Szabolcs, Tóth Richárd, Keszthelyi Márton
Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary.
Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary.
Cancers (Basel). 2025 Mar 8;17(6):921. doi: 10.3390/cancers17060921.
Cervical cancer, primarily driven by persistent high-risk human papillomavirus (HPV) infections, remains a significant global health challenge. Systemic inflammatory markers, such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR), may reflect disease progression. This study examines the association between these markers and p16 positivity in cervical intraepithelial neoplasia (CIN) cases. This retrospective analysis included 395 patients undergoing LEEP conization. Data on HPV status, p16 immunostaining, and hematological parameters were collected. Statistical analyses, including Mann-Whitney U and chi-square tests, assessed relationships between markers and outcomes, with significance set at < 0.05. Elevated NLR was significantly associated with p16 positivity ( = 0.011) and HPV DNA positivity ( = 0.04). HPV-positive individuals showed higher mean NLR (2.15) compared to HPV-negative individuals (1.61). Receiver operating characteristic (ROC) analysis demonstrated moderate diagnostic accuracy for NLR (AUC = 0.610), highlighting its potential as a biomarker. No significant associations were observed for PLR or LMR with p16 positivity. These findings suggest systemic inflammation, indicated by NLR, contributes to HPV persistence and CIN progression. NLR is a valuable prognostic biomarker for HPV-related cervical disease, correlating with both p16 and HPV DNA positivity. Incorporating hematological and immunohistochemical markers may enhance personalized cervical cancer management.
宫颈癌主要由持续性高危型人乳头瘤病毒（HPV）感染引起，仍然是一项重大的全球健康挑战。全身炎症标志物，如中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）和淋巴细胞/单核细胞比值（LMR），可能反映疾病进展。本研究探讨这些标志物与宫颈上皮内瘤变（CIN）病例中p16阳性之间的关联。这项回顾性分析纳入了395例行环形电切术（LEEP）锥切的患者。收集了HPV状态、p16免疫组化染色和血液学参数的数据。包括Mann-Whitney U检验和卡方检验在内的统计分析评估了标志物与结果之间的关系，显著性设定为<0.05。NLR升高与p16阳性（P = 0.011）和HPV DNA阳性（P = 0.04）显著相关。与HPV阴性个体（1.61）相比，HPV阳性个体的平均NLR更高（2.15）。受试者工作特征（ROC）分析显示NLR具有中等诊断准确性（AUC = 0.610），突出了其作为生物标志物的潜力。未观察到PLR或LMR与p16阳性之间存在显著关联。这些发现表明，NLR所指示的全身炎症有助于HPV持续感染和CIN进展。NLR是HPV相关宫颈疾病的一种有价值的预后生物标志物，与p16和HPV DNA阳性均相关。纳入血液学和免疫组化标志物可能会加强宫颈癌的个体化管理。
