Preoperative predictors of concurrent endometrial carcinoma in patients with endometrial intraepithelial neoplasia: the role of HALP score and other inflammatory markers.

Objective: The aim of this study was to identify preoperative factors that predict concurrent endometrial carcinoma in patients with endometrial intraepithelial neoplasia (EIN), focusing on inflammatory markers, such as hemoglobin, albumin, lymphocyte, and platelet (HALP) score, prognostic nutritional index (PNI), the modified systemic inflammatory score (mSIS), clinical characteristics, and imaging findings.

Material and methods: A retrospective review was conducted of patients diagnosed with EIN who underwent hysterectomy and bilateral salpingo-oophorectomy between 2019 and 2024. Data collected included demographic details, cancer antigen-125 levels, hematological parameters, HALP score, PNI, mSIS, and preoperative endometrial thickness. Statistical analyses were performed to evaluate the associations between these factors and concurrent endometrial carcinoma.

Results: Concurrent endometrial carcinoma was identified in 39 (19.9%) of the total of 196 patients included. Significant predictors included older age (p<0.001), lower platelet count (p<0.001), and endometrial thickness greater than 13 mm (p=0.044). Inflammatory markers such as the HALP score, PNI, and mSIS did not show significant associations. The majority of cases with carcinoma were International Federation of Gynecology and Obstetrics stage IA (76.9%) and grade 1 endometrioid tumors (94.9%).

Conclusion: Advanced age, reduced platelet count, and increased endometrial thickness are key predictors of concurrent endometrial carcinoma in patients with EIN. These findings may be useful for improved preoperative risk stratification and inform surgical planning. Further research is needed to explore the role of inflammatory biomarkers in this context.