Objective: This study aimed to evaluate the efficacy of a new biomarker, termed SIR-En, in identifying patients at risk of endometrial carcinoma among those presenting with abnormal uterine bleeding during menopause. Material and Methods: A retrospective case–control analysis was conducted on 242 women with menopausal abnormal uterine bleeding and endometrial thickness ≥ 4 mm. Peripheral blood samples were collected within 7 days before histological diagnosis. systemic inflammatory reaction (SIR) indices were calculated, including NLR, MLR, PLR, and SII. SIR-En was derived by multiplying SII and endometrial thickness. Statistical analyses, including multivariate linear regression and ROC curve analysis, were performed to assess the diagnostic capability of SIR-En. Results: Patients were categorized into endometrial hyperplasia (50 patients) and endometrial cancer (192 patients) groups. The SIR-En index was significantly higher in the carcinoma group (8710 vs. 6420;p= 0.003). The ROC curve for SIR-En had an AUC of 0.6351 (95% CI: 0.5579–0.7121). Using Youden’s method, the optimal SIR-En cutoff was 13,806, showing a specificity of 0.940 and a positive predictive value of 0.957. Conclusions: Combining systemic inflammatory indices with endometrial thickness, the SIR-En index can effectively distinguish between endometrial hyperplasia and carcinoma in menopausal women with abnormal uterine bleeding. Despite the retrospective design, the identified cutoff’s high specificity and positive predictive value support its potential utility in clinical practice. Further prospective studies are required to validate these findings and optimize clinical application.
目的：本研究旨在评估一种新型生物标志物SIR-En在绝经期异常子宫出血患者中识别子宫内膜癌风险的有效性。材料与方法：对242例绝经期异常子宫出血且子宫内膜厚度≥4 mm的女性进行回顾性病例对照分析。在组织学诊断前7天内采集外周血样本，计算全身炎症反应（SIR）指标，包括中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、血小板与淋巴细胞比值（PLR）及全身免疫炎症指数（SII）。SIR-En由SII与子宫内膜厚度相乘得出。通过多因素线性回归及受试者工作特征（ROC）曲线分析评估SIR-En的诊断能力。结果：患者分为子宫内膜增生组（50例）和子宫内膜癌组（192例）。癌组SIR-En指数显著更高（8710 vs. 6420；p=0.003）。SIR-En的ROC曲线下面积（AUC）为0.6351（95% CI：0.5579–0.7121）。根据约登指数法，最佳SIR-En截断值为13,806，特异性为0.940，阳性预测值为0.957。结论：结合全身炎症指标与子宫内膜厚度，SIR-En指数能有效区分绝经期异常子宫出血女性的子宫内膜增生与癌变。尽管为回顾性研究，但所确定的截断值具有高特异性和阳性预测值，支持其临床应用的潜在价值。需进一步开展前瞻性研究以验证结果并优化临床应用。
肿瘤(癌症)患者之家