Objective: This study aimed to evaluate the predictive value of systemic inflammatory markers, particularly the Neutrophil Percentage to Albumin Ratio (NPAR), in identifying high-grade cervical intraepithelial neoplasia (CIN) in patients undergoing colposcopy and cervical conization. Materials and Methods: A retrospective analysis was conducted on 116 patients who underwent cervical conization between January 2020 and May 2024. Demographic, clinical, and laboratory data were collected, and inflammatory indices, including NPAR, NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio), and SII (Systemic Immune-Inflammation Index), were calculated. Sample size estimation was based on prior studies assessing inflammatory markers in CIN, ensuring adequate statistical power for detecting differences in biomarker levels. ROC curve analysis was performed to assess the diagnostic accuracy of these markers. Results: NPAR demonstrated the highest predictive value for high-grade CIN, with an AUC of 0.893. Significant correlations were found between NPAR and other systemic inflammatory markers, such as NLR and SII. However, NLR and PLR showed lower predictive accuracy compared to NPAR. Conclusion: NPAR is a valuable biomarker for predicting high-grade CIN and can aid in patient stratification and treatment planning. Integrating NPAR with other systemic markers may enhance the accuracy of clinical decisions. Further studies with larger cohorts are recommended to validate these findings and explore their clinical utility.

Background: Endometrial carcinoma, EC is the most common gynecologic malignancy in developed countries, and identifying accessible prognostic markers remains critical for guiding treatment strategies. Systemic inflammatory markers have emerged as promising tools in cancer prognosis. Objective: This study aimed to investigate the predictive value of the neutrophil percentage-to-albumin ratio, NPAR in patients diagnosed with endometrial carcinoma and to compare its utility with other systemic inflammatory indices. Methods: This retrospective study included 194 patients who underwent surgical treatment for endometrial carcinoma between January 2020 and May 2025 at a tertiary care center. Preoperative blood samples were used to calculate neutrophil percentage-to-albumin ratio, NPAR, neutrophil-to-lymphocyte ratio, NLR, platelet-to-lymphocyte ratio, PLR, systemic immune-inflammation index, SII, and other related markers. Patients were analyzed according to final pathological outcomes, and the relationship between inflammatory indices and prognostic parameters such as tumor grade, histologic type, depth of myometrial invasion, lymphovascular space invasion, LVSI and FIGO stage was evaluated. Receiver operating characteristic, ROC analysis was performed to determine optimal cutoff values for NPAR. Results: NPAR did not show a statistically significant association with lymphovascular space invasion (LVSI) or deep myometrial invasion. However, it was significantly associated with advanced stage (FIGO ≥ Stage II). High NPAR, elevated SIRI, high PLR, low NLR, elevated MLR, and increased immature granulocyte count were significant predictors of advanced stage. The regression model demonstrated strong predictive ability for advanced disease (Nagelkerke R² = 0.79; p < 0.001). Conclusion: NPAR is a novel, simple, and cost-effective prognostic biomarker in endometrial carcinoma. Its preoperative evaluation may help identify high-risk patients and contribute to more individualized treatment planning. Further prospective studies are warranted to validate these findings.

Background: Ovarian torsion is a medical emergency caused by ovarian rotation and requires prompt diagnosis and treatment to prevent complications such as ovarian necrosis. In our study, we aimed to predict ovarian torsion by evaluating preoperative neutrophil percentage-to-albumin ratio (NPAR) and inflammatory parameters among patients with ovarian cyst and ovarian torsion. Methods: This retrospective study includes 167 patients who underwent surgery for ovarian cysts or ovarian torsion between January 2021 and May 2024 at Konya City Hospital. Clinical characteristics, along with preoperative hematologic and inflammatory parameters, were compared between patients with and without torsion. Results: There was no significant difference in ovarian cyst size or cyst lateralization between the ovarian cyst and ovarian torsion groups (p = 0.595 and p = 0.932, respectively). Neutrophil percentage, neutrophil count, white blood cell (WBC) count, NPAR, and neutrophil-to-lymphocyte ratio (NLR) were higher in the ovarian torsion group (n = 83) compared to the ovarian cyst group (n = 84) (all p < 0.01). Lymphocyte count was lower in the ovarian torsion group. Although the systemic immune-inflammation index (SII) was higher in the torsion group, the difference was not statistically significant. A correlation analysis was performed between patient age, ovarian cyst size, and inflammatory parameters in the ovarian torsion group. When the NPAR cut-off was set at 1.66, high sensitivity (80.7%) and specificity (95.2%) were observed for ovarian torsion. The positive predictive value (PPV) was 94.3%, and the negative predictive value (NPV) was 83.3%. The area under the curve (AUC) for NPAR was 0.892 (95% confidence interval (CI): 0.837–0.947), indicating strong predictive performance (p = 0.001). Conclusions: The higher levels of NPAR, NLR, WBC count, neutrophil percentage, and neutrophil count observed in ovarian torsion cases suggest that these parameters may be useful in diagnosing ovarian torsion. In addition, the high sensitivity and specificity values of NPAR highlights its potential for future studies in the diagnosis of ovarian torsion.

Objective: This study aims to evaluate the diagnostic value of high-risk human papillomavirus (HR-HPV) positivity—particularly HPV type 16—together with cytological findings and colposcopic assessment in detecting cervical intraepithelial neoplasia (CIN) and cervical cancer. Materials and Methods: We retrospectively analyzed 781 women who underwent colposcopic examination at a tertiary healthcare center between January 2020 and April 2024. HPV DNA results and cytological evaluations prior to colposcopy were reviewed. Histopathological outcomes from cervical biopsy, endocervical curettage (ECC), and probe curettage (P/C) were examined. Multivariate logistic regression was used to determine the predictors of CIN 2 or more severe lesions. Results: HPV type 16 was found to be a significant independent predictor of CIN2+ lesions, with an odds ratio of 22.36 (p=0.002) compared to HPV-negative individuals. The model demonstrated statistical significance, and the area under the curve (AUC) was calculated as 0.679, indicating moderate diagnostic performance. Other HPV genotypes and unknown HPV status also showed a significant association with higher-grade lesions. Conclusion: HR-HPV, and particularly HPV 16, is strongly associated with the presence of advanced cervical lesions. Women testing positive for HPV 16 should undergo close surveillance and timely colposcopic evaluation by specialists to enable early diagnosis and prevent progression to invasive cervical cancer.

Objective: To investigate the impact of the COVID-19 pandemic on the diagnosis and treatment processes of ectopic pregnancies (EP) at a tertiary hospital in Turkey. Methods: This retrospective study compared 221 cases of tubal EP diagnosed after March 15, 2020, with 217 cases diagnosed before this date. Patient demographics, clinical characteristics, and treatment modalities were analyzed. Statistical analyses, including independent t-tests, Chi-square tests, and multinomial logistic regression, were conducted to assess differences between the COVID and pre-COVID periods. Results: The study found no significant differences in maternal age, gravidity, parity, or gestational weeks between the COVID and pre-COVID periods. However, there was a notable increase in patients presenting with abdominal pain (52.5% vs. 37.8%) and intraperitoneal hemorrhage (26.7% vs. 7.4%) during the COVID period. Despite the higher frequency of abdominal pain, vaginal bleeding was less common during the pandemic. Treatment approaches also shifted, with a significant increase in medical management (41.2% vs. 29.0%) and a slight decrease in surgical interventions during the COVID period. Multinomial logistic regression revealed that parity, gestational week, presence of Douglas fluid, and the period of diagnosis (COVID vs. pre-COVID) were significant predictors of treatment modality. Conclusion: The COVID-19 pandemic influenced the clinical presentation and management of ectopic pregnancies in our hospital. While there were no significant differences in key demographic or laboratory parameters, the increased presence of abdominal fluid and a shift towards medical management during the pandemic period suggest changes in patient presentation and treatment preferences. This study underscores the importance of maintaining vigilant diagnostic and therapeutic approaches for EP, even during global health crises.