SIR-EN—New Biomarker for Identifying Patients at Risk of Endometrial Carcinoma in Abnormal Uterine Bleeding at Menopause.

Simple Summary: This study investigated the relationship between systemic inflammatory reaction (SIR) indices and endometrial thickness in postmenopausal women with abnormal uterine bleeding. A new biomarker, SIR-En, combining SII (Systemic Inflammatory Index) and endometrial thickness, was developed. This study compared 192 patients with endometrial cancer and 50 with endometrial hyperplasia. The results showed that patients with cancer had significantly higher SIR-En values than those with hyperplasia (8710 vs. 6420; p = 0.003). The SIR-En index demonstrated moderate diagnostic ability for endometrial cancer, with an area under the ROC curve (AUC) of 0.6351 and a cut-off of 13,806, yielding high specificity (94%) and positive predictive value (96%). This suggests that SIR-En could aid in discriminating the endometrial carcinoma from atypical hyperplasia, improving diagnosis and treatment strategies. Objective: This study aimed to evaluate the efficacy of a new biomarker, termed SIR-En, in identifying patients at risk of endometrial carcinoma among those presenting with abnormal uterine bleeding during menopause. Material and Methods: A retrospective case–control analysis was conducted on 242 women with menopausal abnormal uterine bleeding and endometrial thickness ≥ 4 mm. Peripheral blood samples were collected within 7 days before histological diagnosis. systemic inflammatory reaction (SIR) indices were calculated, including NLR, MLR, PLR, and SII. SIR-En was derived by multiplying SII and endometrial thickness. Statistical analyses, including multivariate linear regression and ROC curve analysis, were performed to assess the diagnostic capability of SIR-En. Results: Patients were categorized into endometrial hyperplasia (50 patients) and endometrial cancer (192 patients) groups. The SIR-En index was significantly higher in the carcinoma group (8710 vs. 6420; p = 0.003). The ROC curve for SIR-En had an AUC of 0.6351 (95% CI: 0.5579–0.7121). Using Youden's method, the optimal SIR-En cutoff was 13,806, showing a specificity of 0.940 and a positive predictive value of 0.957. Conclusions: Combining systemic inflammatory indices with endometrial thickness, the SIR-En index can effectively distinguish between endometrial hyperplasia and carcinoma in menopausal women with abnormal uterine bleeding. Despite the retrospective design, the identified cutoff's high specificity and positive predictive value support its potential utility in clinical practice. Further prospective studies are required to validate these findings and optimize clinical application. [ABSTRACT FROM AUTHOR]