{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:01:47Z","timestamp":1791198107563,"version":"4.1.0"},"reference-count":73,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>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\u2013control study, all women with endometrial intraepithelial neoplasia (EIN) or uterine malignancy on curettage for abnormal uterine bleeding (January 2021\u2013June 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 (\u0394C) the effect measure, with \u0394C \u2265 0.02 taken as clinically relevant, and performance was internally validated by bootstrapping and cross-validation. Results: Cases were 93 carcinomas and 43 EINs. Age (AUC 0.792, 95% CI 0.744\u20130.841) and endometrial thickness (0.749, 0.697\u20130.800) discriminated better than any index; SIRI was best (0.621, 0.564\u20130.678) and PLR did not discriminate (0.510). The clinical model reached a C-statistic of 0.882 (0.844\u20130.919), inflated by design; optimism-corrected calibration slope 0.963. No index remained significant after adjustment (smallest p = 0.141); the largest \u0394C was +0.0042 (\u22120.0027 to +0.0111). The six log-indices are algebraically dependent, so the joint model used an identifiable four-index basis; it added +0.0064 (\u03c724 = 4.48, p = 0.345), an increment that vanished on validation (optimism-corrected \u22120.0001; cross-validated +0.0010, \u22120.0076 to +0.0097). Accuracy at the Youden cut-off was 83.5% (clinical) and 81.7\u201384.2% (index models). Twelve sensitivity analyses agreed. Conclusions: None of the six indices provided detectable incremental discrimination once age, menopausal status and endometrial thickness were accounted for; their univariable associations reflect the clinical profile of affected women rather than an independent biological signal.<\/jats:p>","DOI":"10.3390\/diagnostics16193219","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:02:27Z","timestamp":1791194547000},"page":"3219","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Limited Incremental Value of Six Haemogram-Derived Inflammatory Indices for Detecting Endometrial Carcinoma and Intraepithelial Neoplasia in Abnormal Uterine Bleeding: A Case\u2013Control Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0987-740X","authenticated-orcid":false,"given":"Senem","family":"Karacabey Cakmak","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Haseki Training and Research Hospital, University of Health Sciences, 34265 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6190-3727","authenticated-orcid":false,"given":"Busra","family":"Seker Atas","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Haseki Training and Research Hospital, University of Health Sciences, 34265 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1748-0715","authenticated-orcid":false,"given":"Ezgi","family":"Gungor","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Denizli \u00c7al State Hospital, 20700 Denizli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7185-7000","authenticated-orcid":false,"given":"Kubra","family":"Sevim Pehlivan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Osmaniye Training and Research Hospital, University of Health Sciences, 80010 Osmaniye, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"04155","DOI":"10.7189\/jogh.14.04155","article-title":"Global burden of gynaecological cancers in 2022 and projections to 2050","volume":"14","author":"Zhu","year":"2024","journal-title":"J. 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