Correlation between Inflammatory Index, Endometrial Thickness, and Lymphovascular Space Invasion in Endometrial Cancer: A Prospective Observational Study

Background: Lymphovascular space invasion (LVSI) is recognized as a significant prognostic factor in endometrial cancer. Systemic inflammation, as reflected by neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) indices, may reflect or contribute to tumor progression. Increased endometrial thickness (ET) may also promote local invasion. Our study aims to discover the relationship between these parameters. Methods: In this prospective study, we examined 161 patients with endometrial carcinoma treated at the Azienda Ospedaliera Universitaria Vanvitelli in Naples, Italy. The variables examined included inflammatory indices such as NLR, MLR, and PRL, as well as ultrasound-measured ET (mm). Statistical analysis was performed to compare the groups with and without LVSI and to evaluate the association between inflammatory indices, ET, and the presence of LVSI. Results: The LVSI-positive group showed statistically significantly higher average values for all analyzed parameters. Logistic regression analysis revealed an interdependence between NLR, MLR, PLR, ET, and LVSI. Multivariate logistic regression confirmed that ET is a significant predictor of LVSI. Conclusion: The results of our analysis suggest an interaction between inflammation, ET, and LVSI in endometrial cancer. Logistic regression demonstrated that ET is a significant predictor of positive LVSI, while the other inflammatory indices showed a less defined correlation. Clinical Trial Registration: NCT05657483, https://clinicaltrials.gov/ct2/show/NCT05657483.