Study Of The Association Between Systemic Inflammatory Indexes And The Occurrence And Development Of Cervical Cancer

Background: Inflammation is closely related to the occurrence and development of cancer.The systemic inflammatory indexes have been reported as prognostic factors for cervical cancer,but their predictive value in the progression of cervical precancerous lesions and cervical cancer has not been clearly studied.Our study aimed to look for systemic inflammatory indexes that could identify disease progression in patients with cervical lesions.Methods: The retrospective study covered 3099 hospitalized patients.The differences of systemic inflammation response index(SIRI),lymphocyte monocyte ratio(LMR),systemic immune-inflammation index(SII),neutrophil lymphocyte ratio(NLR),and platelet lymphocyte ratio(PLR)values before any treatment were analyzed in patients with normal cervix,cervical intraepithelial neoplasia(CIN)and cervical cancer,as well as during the progression of CIN Ⅰ to CIN Ⅲ.The diagnostic value of these indexes for the progression of Normal to CIN,CIN to cervical cancer and Normal to cervical cancer was evaluated by receiver operating characteristic curve.Multivariate analysis was performed to identify the independent predictors of CIN progression to cervical cancer.The effects of human papillomaviruses(HPV)infection on the systemic inflammatory indexes were also explored in the Normal and the CIN groups.Results: In cervical lesions progression from Normal to CIN and then to cervical cancer,SIRI,SII and NLR decrease at first,then increase to greater than the normal level,while LMR decreases to lower than the normal level after an initial increase.All four indexes have good predictive value for progression from CIN to cervical cancer.The PLR during this process was not statistically significant and has poor predictive value.These results indicate that during the development of cervical lesions,inflammatory responses are to weaken in the early stage and then strengthen.SIRI,LMR,SII and NLR are independent predictors for CIN progress to cervical cancer.In addition,there is no significant difference in the five systemic inflammatory indexes between patients with and without HPV infection in the Normal and CIN groups,which suggests that HPV may be confined to the site of infection and does not affect systemic inflammatory response.Conclusions: The results of this study are helpful to clarify the dynamic mechanism of systemic inflammation in the lesion process of cervix and showed the ability of systemic inflammatory indexes to identify the direction of cervical lesions progression,which could guide the clinical diagnose and prevention of cervical cancer.