Ovarian cancer during pregnancy: Pregnancy‐adjusted inflammatory and haematologic signatures for earlier risk recognition and clinical decision‐making

Abstract Background Ovarian cancer during pregnancy presents a diagnostic challenge because physiological pregnancy‐associated haematologic and inflammatory changes can overlap with malignancy‐associated abnormalities, while conventional tumour biomarkers, particularly cancer antigen 125 (CA‐125), may have reduced specificity. Histopathological examination remains the definitive diagnostic standard, with ultrasound and, when indicated, magnetic resonance imaging providing the principal basis for non‐invasive assessment. Objective This mini‐review examines the potential contribution of inflammatory markers and haematologic shifts to improving risk recognition and clinical decision‐making in ovarian cancer during pregnancy. Methods A focused narrative literature review was conducted using relevant peer‐reviewed literature on ovarian cancer during pregnancy, pregnancy‐associated haematologic changes, inflammatory mediators, systemic inflammatory indices, tumour biomarkers, imaging, and clinical decision‐making. Evidence was critically synthesised to examine diagnostic limitations and the potential role of pregnancy‐adjusted inflammatory and haematologic profiles in improving risk recognition and clinical assessment. Results Pregnancy‐associated changes in neutrophils, lymphocytes, platelets, haemoglobin and monocytes are considered alongside tumour‐associated inflammatory processes involving interleukin‐6, interleukin‐8, tumour necrosis factor‐α, transforming growth factor‐β, vascular endothelial growth factor and related pathways. The potential utility of neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, systemic immune‐inflammation index, systemic inflammation response index and lymphocyte‐to‐monocyte ratio is critically evaluated. Particular emphasis is placed on the distinction between physiological gestational variation and persistent or disproportionate inflammatory trajectories. Conclusion Inflammatory and haematologic markers should not be regarded as stand‐alone diagnostic tests for ovarian cancer during pregnancy. Their greatest potential may lie in pregnancy‐adjusted, longitudinal interpretation integrated with clinical assessment, imaging and tumour biomarkers. Prospective multicentre studies are required to establish gestational‐age‐specific reference ranges and validate integrated predictive models.'