Neutrophil-to-lymphocyte ratio (nlr) as a predictor of endometriosis occurrence and prognosis: Evidence from a single-center study in Indonesia

Intoduction Endometriosis is a chronic inflammatory condition characterized by the presence of endometrial tissue outside the uterus, leading to pelvic pain and infertility. It affects approximately 10% of women of reproductive age. Endometriosis is associated with a chronic inflammatory process that results in pain, tissue remodelling, fibrosis, adhesions, and infertility. Numerous chronic inflammatory indicators can serve as practical prognostic and diagnostic biomarkers for the severity of the disease, one of which is the neutrophil-lymphocyte ratio (NLR). The normal range of NLR is 1–3, with mild stress falling within the range of 6–9, and critical conditions being indicated by values above 9. Aim of study This study aimed to investigate the association between endometriosis and the neutrophil-lymphocyte ratio (NLR). Methods The study was conducted at Margono Soekarjo General Hospital in Indonesia and involved all women who suspected endometriosis between January 2022 and May 2024. Several inclusion and exclusion criteria were applied. Statistical analysis was peformed to calculate the odds ratio. Results The study found that women with endometriosis had 4.80 times higher odds [OR 4.8, 95% CI, p = 0.001] of having an elevated NLR compared to those without endometriosis. This means that women with endometriosis have a 4.80 higher risk of having an elevated NLR compared to women without endometriosis. Conclusions There is a statistically significant association between endometriosis and NLR. NLR can serve as a biomarker with a potential role in the diagnosis and prognosis of endometriosis. Women with symptoms of endometriosis can undergo an NLR examination as a predictor or a pre-surgery assessment before confirmation through surgery and histopathological examination.