Limited Incremental Value of Six Haemogram-Derived Inflammatory Indices for Detecting Endometrial Carcinoma and Intraepithelial Neoplasia in Abnormal Uterine Bleeding: A Case–Control Study

Background/Objectives: Haemogram-derived inflammatory indices are proposed as inexpensive markers of endometrial neoplasia, but almost all supporting evidence is prognostic, from women already known to have carcinoma. We compared six indices head-to-head and asked whether any improved discrimination beyond a clinical model of age, menopausal status, endometrial thickness and metabolic comorbidity.

Methods

In this single-centre retrospective case–control study, all women with endometrial intraepithelial neoplasia (EIN) or uterine malignancy on curettage for abnormal uterine bleeding (January 2021–June 2026) were identified (136 cases); 272 benign controls were drawn at a fixed 1:2 ratio. Indices were recalculated de novo from raw differential counts. Each log-transformed index was added singly to the fixed model; the likelihood-ratio test was the primary test and the change in C-statistic (ΔC) the effect measure, with ΔC ≥ 0.02 taken as clinically relevant, and performance was internally validated by bootstrapping and cross-validation.