Additional Risk Factors Lead to a Measurable Inflammatory Response in Stage I Endometrial Cancer—A Prospective Multicentric Observational Study

The objective of the study is to explore the correlation between inflammation indices (NLR, MLR, PLR) and prognostic factors (myometrial infiltration, LVSI, grading) in FIGO 2023 stage I endometrial carcinoma. From August 2023 to March 2024, a prospective study was conducted on 163 women diagnosed with stage I endometrial cancer. The research methods were established a priori and authorized through evaluation by the Ethics Committee of the individual centers (IRB 30661/2022 of 31/03/2022). The study was then registered on the clinicaltrials.gov platform under NCT05657483. Blood samples were collected preoperatively to measure the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR). Histopathological data on myometrial infiltration, LVSI, and grading were also analyzed. NLR values were 2.07, 2.35, and 2.68 for no infiltration, < 50%, and ≥ 50% myometrial infiltration, respectively (<i>p</i> = 0.033). MLR values were 0.20, 0.23, and 0.26 for the same categories (<i>p</i> = 0.029). PLR values were 119, 140, and 146 (<i>p</i> = 0.043). For LVSI, NLR was 2.17 in negative and 3.23 in diffuse (<i>p</i> = 0.010), while MLR showed 0.20 vs 0.24 (<i>p</i> = 0.054), and PLR showed 125 vs 141 (<i>p</i> = 0.033). Multivariate analysis indicated myometrial infiltration had the strongest correlation with inflammation indices (beta 0.07, CI 95% 0.01-0.13, <i>p</i> = 0.041). Inflammation indices (NLR, MLR, PLR) significantly correlate with myometrial infiltration, LVSI positivity, and higher grading in early-stage endometrial carcinoma, with myometrial infiltration showing the strongest association. These findings suggest that inflammation indices could aid in the prognostic evaluation of endometrial carcinoma. Further research is needed to understand the prognostic implications fully.