Background: Cervical cancer is a major global health concern, particularly in low-resource settings where access to advanced diagnostics is limited. The neutrophil-to-lymphocyte ratio (NLR), a systemic inflammatory marker, has shown prognostic significance in various malignancies. However, its role in predicting cervical cancer in patients undergoing conization remains unclear.Objectives: This study evaluated NLR’s diagnostic and predictive value in identifying malignancy in conization outcomes.Methods: This retrospective study analyzed 374 patients from the SCOPE study. Preoperative NLR levels were assessed with conization histopathology outcomes using the Kruskal–Wallis test, Mann–Whitney U test, logistic regression, and receiver operating characteristic (ROC) curve analysis.Results: NLR levels were significantly higher in patients with malignant conization outcomes (χ2= 15.988,p= 0.001). A cut-off NLR ≥ 2.86 significantly predicted cervical cancer presence (p= 0.045). Logistic regression showed that each unit increase in the NLR increased cancer likelihood by 37.2% (p= 0.008). ROC analysis demonstrated moderate diagnostic accuracy (AUC = 0.734), with an optimal NLR cut-off of ≥1.865 yielding 87.0% sensitivity and 53.8% specificity.Conclusions: Our findings suggest that the NLR may serve as a promising, easily accessible, non-invasive biomarker with modest predictive value for cervical cancer in patients undergoing conization. Future studies should focus on validating the NLR in combination with other biomarkers, such as HPV genotyping and molecular markers, to improve diagnostic accuracy, particularly in low-resource settings.
背景：宫颈癌是全球性的重大健康问题，尤其在医疗资源匮乏地区，先进诊断技术的可及性有限。中性粒细胞与淋巴细胞比值（NLR）作为全身性炎症标志物，已在多种恶性肿瘤中显示出预后价值，但其在预测接受锥切术患者宫颈癌发生风险中的作用尚不明确。 目的：本研究旨在评估NLR对锥切术后病理结果中恶性肿瘤的鉴别诊断及预测价值。 方法：本研究回顾性分析了SCOPE研究中的374例患者数据。通过Kruskal-Wallis检验、Mann-Whitney U检验、逻辑回归分析和受试者工作特征（ROC）曲线分析，评估术前NLR水平与锥切组织病理学结果的相关性。 结果：锥切病理结果为恶性的患者NLR水平显著升高（χ²=15.988，p=0.001）。当NLR截断值≥2.86时，对宫颈癌存在具有显著预测价值（p=0.045）。逻辑回归分析显示，NLR每增加一个单位，患癌概率增加37.2%（p=0.008）。ROC曲线分析显示中等诊断效能（AUC=0.734），当NLR最佳截断值≥1.865时，敏感度为87.0%，特异度为53.8%。 结论：本研究提示NLR可能成为一种具有应用前景、易于获取且无创的生物标志物，对接受锥切术患者的宫颈癌风险具有中等程度的预测价值。未来研究应重点验证NLR与人乳头瘤病毒（HPV）基因分型、分子标志物等指标的联合应用，以提高诊断准确性，特别是在医疗资源匮乏地区。
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