Background: Cervical cancer continues to pose a significant global health challenge,
particularly in low-resource regions with limited access to advanced diagnostics.
Cervical conization can occasionally uncover invasive carcinoma in patients initially
suspected of having only pre-invasive lesions. This study assessed the platelet-to-lymphocyte
ratio (PLR) as a potential predictive biomarker for identifying invasive disease in
patients undergoing a loop electrosurgical excision procedure (LEEP). Methods: A retrospective
study was conducted on 371 patients who underwent LEEP conization for cervical dysplasia.
Preoperative PLR values were collected and compared across final histopathological
categories (negative, low-grade, high-grade, invasive carcinoma) using the Kruskal–Wallis
test, followed by Mann–Whitney U tests for pairwise comparisons. Receiver operating
characteristic (ROC) analysis was used to evaluate diagnostic accuracy. Results: PLR
values above 7.7 were significantly associated with HPV positivity, increasing with
histopathological severity. There were significant PLR differences across the outcome
groups (p = 0.005), with notably higher values in cases of invasive carcinoma (p <
0.01). ROC analysis showed moderate diagnostic utility (AUC ≈ 0.72); at a PLR cutoff
of ~11.9, sensitivity was 65% and specificity 81%. Conclusions: The PLR cutoff of
7.7 was associated with HPV positivity, while a higher cutoff of 11.93 was identified
for predicting invasive cervical cancer. These findings support that preoperative
PLR is a non-invasive, clinically relevant marker correlated with lesion severity,
offering potential for preoperative risk stratification, particularly where advanced
diagnostics are limited.
