{"paper_id":"d9dba10f-ace2-421a-8cfe-e161cb17d5d0","body_text":"Abstract\nBackground\nThis study sought to examine the function of hematological inflammatory markers in differentiating endometrioma from other benign ovarian cysts prior to surgery and in individuals with Douglas infiltration.\nMaterials and methods\nThe study was designed retrospectively and included 480 patients (321 endometrioma, 159 non-endometrioma) who were operated on for benign ovarian cysts at Mersin University Hospital between January 1, 2004, and March 1, 2024. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), Pan-immune inflammation value (PIV), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were analyzed as hematological inflammatory markers. Additionally, the indices were evaluated in patients with Douglas infiltration, and ROC analysis was conducted to determine their predictive power.\nResults\nThe average age of patients with endometrioma did not show a significant difference compared to the average of patients with other benign ovarian cysts (39.0 vs. 40.0 years, p = 0.174). NLR, PLR, SII, and SIRI were significantly higher in the endometrioma group (p < 0.001). SIRI had the highest value (0.894) in distinguishing endometrioma from other benign ovarian cysts. Douglas infiltration was found to be significantly high with SII, PIV, and PLR having AUCs of 0.580, 0.567, and 0.564, respectively.\nConclusion\nHematological inflammatory markers, particularly SIRI, were found to be useful in distinguishing endometriomas from other benign ovarian cysts, and PLR was identified as a potential non-invasive biomarker when analyzing its predictive power in patients with Douglas infiltration.\nAbbreviations\n- NLR:\n-\nNeutrophil-lymphocyte ratio\n- PLR:\n-\nPlatelet-lymphocyte ratio\n- PIV:\n-\nPan-immune inflammation value\n- SII:\n-\nSystemic immune-inflammation index\n- SIRI:\n-\nSystemic inflammation response index\n- ROC:\n-\nA receiver operating characteristic\n- AUC:\n-\nArea under the curve\n- MRI:\n-\nMagnetic resonance imaging\nAcknowledgements\nNot applicable.\nFunding\nThe authors have no relevant financial or non-financial interests to disclose.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nEthics approval and consent to participate\nThis study was performed in line with the principles of the Declaration of Helsinki. The study protocol was approved by the Clinical Research Ethics Committee of Mersin University Rectorate (with the ethics committee decision numbered 2024/624 dated 10/07/2024). Informed consent was obtained from all individual participants included in the study.\nConsent for publication\nNot applicable.\nCompeting interests\nThe authors declare no competing interests.\nAdditional information\nPublisher’s note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nOpen Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.\nAbout this article\nCite this article\nYildiz, H., Akay, K., Ulger, G. et al. Association of systemic inflammatory markers with endometrioma diagnosis and Douglas infiltration: a retrospective analysis. BMC Women's Health (2026). https://doi.org/10.1186/s12905-026-04859-4\nReceived:\nAccepted:\nPublished:\nDOI: https://doi.org/10.1186/s12905-026-04859-4","source_license":"CC0","license_restricted":false}