Preoperative hematological parameters do not predict lesion severity or recurrence in cervical intraepithelial neoplasia: a retrospective cohort study

OBJECTIVE: To evaluate the predictive value of preoperative hematological parameters for determining lesion grade and recurrence risk in patients diagnosed with cervical intraepithelial neoplasia (CIN) by biopsy. MATERIALS AND METHODS: This retrospective study included 700 women who underwent a loop electrosurgical excision procedure (LEEP) following colposcopy at a tertiary referral center. Preoperative complete blood counts obtained within one week before surgery were used to calculate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). These indices were compared according to LEEP histopathology and evaluated for recurrence over a two-year follow-up period. RESULTS: No significant differences were observed in hematologic parameters (NLR, PLR, MLR, SII, SIRI) between low- and high-grade lesions (all p > 0.05). Similarly, among patients with biopsy-proven CIN2, preoperative indices did not differ across final LEEP results. During a 24-month follow-up, histologic recurrence occurred in 6.7% of patients. Recurrence was associated with HPV persistence (p < 0.001), whereas the univariable association with lower MLR values (p = 0.049) did not remain significant after multivariable adjustment. In multivariable analysis, only persistent HPV infection remained an independent predictor of recurrence (OR = 2.98, p = 0.014). ROC analysis showed weak and clinically limited discriminative power for MLR (AUC = 0.61). CONCLUSION: Preoperative hematologic parameters showed no clinically meaningful predictive value for lesion severity or recurrence and should not be used for clinical risk stratification.