Background: 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. Methods: 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 p < 0.05. Results: Elevated NLR was significantly associated with p16 positivity (p = 0.011) and HPV DNA positivity (p = 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. Conclusions: 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.

Background: Cervical cancer is a major global health concern, particularly in low-resource settings where access to advanced diagnostics is limited. The neutrophil-to-lymphocyte ratio (NLR), a systemic inflammatory marker, has shown prognostic significance in various malignancies. However, its role in predicting cervical cancer in patients undergoing conization remains unclear. Objectives: This study evaluated NLR’s diagnostic and predictive value in identifying malignancy in conization outcomes. Methods: This retrospective study analyzed 374 patients from the SCOPE study. Preoperative NLR levels were assessed with conization histopathology outcomes using the Kruskal–Wallis test, Mann–Whitney U test, logistic regression, and receiver operating characteristic (ROC) curve analysis. Results: NLR levels were significantly higher in patients with malignant conization outcomes (χ² = 15.988, p = 0.001). A cut-off NLR ≥ 2.86 significantly predicted cervical cancer presence (p = 0.045). Logistic regression showed that each unit increase in the NLR increased cancer likelihood by 37.2% (p = 0.008). ROC analysis demonstrated moderate diagnostic accuracy (AUC = 0.734), with an optimal NLR cut-off of ≥1.865 yielding 87.0% sensitivity and 53.8% specificity. Conclusions: Our findings suggest that the NLR may serve as a promising, easily accessible, non-invasive biomarker with modest predictive value for cervical cancer in patients undergoing conization. Future studies should focus on validating the NLR in combination with other biomarkers, such as HPV genotyping and molecular markers, to improve diagnostic accuracy, particularly in low-resource settings.

Objectives: This systematic review aimed to evaluate current surgical and non-surgical management strategies for malignant bowel obstruction (MBO) in patients with gynaecological cancer. Methods: Comprehensive literature searches were conducted across MEDLINE, Embase, CENTRAL, and Scopus, without restrictions on language or publication date. Following the removal of duplicates, 4866 articles were screened, with 34 meeting the inclusion criteria. Results: Surgical intervention remains the definitive treatment for MBO, offering longer symptom-free periods and improved survival, particularly when conservative methods fail. However, the selection of surgical candidates is crucial due to the high risk of morbidity and the potential for significant complications. Non-surgical treatments, such as the use of Gastrografin, Octreotide, and Dexamethasone, along with invasive procedures like nasogastric tubing, percutaneous gastrostomy, and stent placement, offer varying degrees of symptom relief and are often considered when surgery is not feasible. Conclusions: In this article we provide a potential therapeutic algorithm for the management of patients with MBO. This review underscores the urgent need for high-quality research to develop clear, evidence-based guidelines for MBO management in patients with gynaecologic cancer. Establishing standardised protocols will improve patient outcomes by aiding clinicians in making informed, individualised treatment decisions.

Background: Cervical cancer continues to pose a significant global health challenge, particularly in low-resource regions with limited access to advanced diagnostics. Cervical conization can occasionally uncover invasive carcinoma in patients initially suspected of having only pre-invasive lesions. This study assessed the platelet-to-lymphocyte ratio (PLR) as a potential predictive biomarker for identifying invasive disease in patients undergoing a loop electrosurgical excision procedure (LEEP). Methods: A retrospective study was conducted on 371 patients who underwent LEEP conization for cervical dysplasia. Preoperative PLR values were collected and compared across final histopathological categories (negative, low-grade, high-grade, invasive carcinoma) using the Kruskal–Wallis test, followed by Mann–Whitney U tests for pairwise comparisons. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic accuracy. Results: PLR values above 7.7 were significantly associated with HPV positivity, increasing with histopathological severity. There were significant PLR differences across the outcome groups (p = 0.005), with notably higher values in cases of invasive carcinoma (p < 0.01). ROC analysis showed moderate diagnostic utility (AUC ≈ 0.72); at a PLR cutoff of ~11.9, sensitivity was 65% and specificity 81%. Conclusions: The PLR cutoff of 7.7 was associated with HPV positivity, while a higher cutoff of 11.93 was identified for predicting invasive cervical cancer. These findings support that preoperative PLR is a non-invasive, clinically relevant marker correlated with lesion severity, offering potential for preoperative risk stratification, particularly where advanced diagnostics are limited.

Cervical cancer, primarily caused by high-risk Human Papilloma Virus (HPV), remains a global health concern. Prognostic biomarkers reflecting systemic inflammation and immune response—the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI)—have recently attracted interest for their potential predictive value in cervical cancer. We conducted a retrospective observational study including 344 patients who underwent loop electrosurgical excision of cervical intraepithelial neoplasia at Semmelweis University, Budapest, Hungary, between 2021 and 2024. Demographic, cytologic, histologic, and laboratory data were collected, and SII and SIRI were calculated. Statistical analyses, including Receiver Operating Characteristic (ROC) analyses, were performed. Higher SII and SIRI values were significantly associated with higher-grade lesions and invasive carcinoma. ROC analyses indicated good discriminatory performance, with negative predictive values of 96–100%, suggesting potential utility in ruling out malignant transformation. SII and SIRI are simple, cost-effective, and minimally invasive biomarkers that correlate with lesion severity in cervical disease. Their high negative predictive value supports a potential role as complementary rule-out tools in diagnostic evaluation. Further prospective studies are needed to validate these findings and to define clinically meaningful cut-off values for routine use.

Background: Cervical cancer remains a major global health burden, particularly in regions with limited early detection. The Loop Electrosurgical Excision Procedure (LEEP) is commonly used to diagnose and treat cervical intraepithelial neoplasia (CIN). The lymphocyte-to-monocyte ratio (LMR) is a potential biomarker for cancer risk stratification. It reflects immune function and tumor-related inflammation. Lower LMR values suggest reduced antitumor immunity and increased tumor-promoting inflammation, which are linked to cancer development and progression. This study examines relationships between preoperative LMR and histopathological outcomes after LEEP. Methods: This retrospective study included 374 patients undergoing the LEEP for cervical dysplasia. Preoperative LMR values were compared across four histopathological categories: negative, low-grade, high-grade lesions, and invasive carcinoma. The Kruskal–Wallis test assessed group differences, with Mann–Whitney U tests for pairwise comparisons. ROC curve analysis (n = 369) evaluated LMR’s diagnostic performance, and logistic regression evaluated its independent predictive value. Results: LMR significantly differed across cytological (p = 0.04) and histological groups (p = 0.036). Post hoc analysis revealed significantly lower LMR in invasive carcinoma versus low-grade lesions in cytology and for both low- and high-grade lesions in histology. ROC analysis yielded an AUC of 0.680. An LMR cutoff <4.49 showed 82.6% sensitivity and 50.0% specificity. Stricter cutoff (<3.89) increased specificity (66.8%) but decreased sensitivity (60.9%). Both had high negative predictive values (97.7% and 96.2%) but low positive predictive values (9.9% and 10.9%). Conclusions: LMR may serve as a complementary biomarker to predict higher-grade cervical lesions and help rule out invasive disease, aiding patient triage in resource-limited settings.