Systemic Inflammatory Indices—Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI)—As Potential Rule-Out Biomarkers for Invasive Cervical Carcinoma

Sep 30, 2026

Cervical cancer caused by high-risk HPV remains a major global health concern. Prognostic biomarkers reflecting systemic inflammation and immune response, including the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI), are evaluated as rule-out indicators. A retrospective study analyzed 344 patients undergoing LEEP for CIN at Semmelweis University (2021–2024), collecting clinical, cytologic, histologic, and laboratory data, and computing SII/SIRI. Higher values correlated with higher-grade lesions and invasive carcinoma, while ROC analyses showed strong discrimination with negative predictive values of 96–100%.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Introduction

Background on cervical cancer and HPV

Role of systemic inflammation and immune response indices

SII and SIRI as biomarkers

Systemic Immune-Inflammation Index (SII)

Systemic Inflammation Response Index (SIRI)

Article Systemic Inflammatory Indices—Systemic ImmuneInflammation Index (SII) and the Systemic Inflammation Response Index (SIRI)—As Potential Rule-Out Biomarkers for Invasive Cervical Carcinoma Márton Keszthelyi 1,†, Réka Eszter Sziva 1, *,†, Zsófia Havrán 2, Verita Szabó 2, Noémi Kalas 2, Lotti L ˝oczi 1, Barbara Seb ˝ok 3, Petra Merkely 1, Nándor Ács 1, Szabolcs Várbíró 3,4, Balázs Lintner 1 and Richárd Tóth 1 Academic Editor: David B. Alexander Received: 11 November 2025 Revised: 27 December 2025 Accepted: 28 December 2025 Published: 31 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Obstetrics and Gynecology, Semmelweis University, Üll˝oi Road 78/A, 1082 Budapest, Hungary; [keszthelyi.marton@semmelweis.hu](keszthelyi.marton@semmelweis.hu) (M.K.); [keszthelyi.lotti.lucia@semmelweis.hu](keszthelyi.lotti.lucia@semmelweis.hu) (L.L.); [merkely.petra@gmail.com](merkely.petra@gmail.com) (P.M.); [acs.nandor@semmelweis.hu](acs.nandor@semmelweis.hu) (N.Á .); [lintner.balazs.zoltan@semmelweis.hu](lintner.balazs.zoltan@semmelweis.hu) (B.L.); [toth.richard@semmelweis.hu](toth.richard@semmelweis.hu) (R.T.) 2 Faculty of Medicine, Semmelweis University, Üll˝oi Road 26, 1085 Budapest, Hungary; zsofi.havran@gmail.com (Z.H.); szabo.verita@gmail.com (V.S.); kalasnoemi@gmail.com (N.K.) 3 Workgroup of Research Management, Doctoral School, Semmelweis University, Üll˝oi Road 26, 1085 Budapest, Hungary; [sebok.barbara23@gmail.com](sebok.barbara23@gmail.com) (B.S.); [varbiroszabolcs@gmail.com](varbiroszabolcs@gmail.com) (S.V.) 4 Department of Obstetrics and Gynecology, University of Szeged, Semmelweis Street 1, 6725 Szeged, Hungary * Correspondence: [sziva.reka@semmelweis.hu](sziva.reka@semmelweis.hu)[ ](sziva.reka@semmelweis.hu)† These authors contributed equally to this work Abstract Cervical cancer, primarily caused by high-risk Human Papilloma Virus (HPV), remains a global health concern. Prognostic biomarkers reflecting systemic inflammation and immune response—the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI)—have recently attracted interest for their potential predictive value in cervical cancer. We conducted a retrospective observational study including 344 patients who underwent loop electrosurgical excision of cervical intraepithelial neoplasia at Semmelweis University, Budapest, Hungary, between 2021 and 2024 . Demographic, cytologic, histologic, and laboratory data were collected, and SII and SIRI were calculated. Statistical analyses, including Receiver Operating Characteristic (ROC) analyses, were performed. Higher SII and SIRI values were significantly associated with higher-grade lesions and invasive carcinoma. ROC analyses indicated good discriminatory performance, with negative predictive values of 96–100%, suggesting potential utility in ruling out malignant transformation. SII and SIRI are simple, cost-effective, and minimally invasive biomarkers that correlate with lesion severity in cervical disease. Their high negative predictive value supports a potential role as complementary rule-out tools in diagnostic evaluation. Further prospective studies are needed to validate these findings and to define clinically meaningful cut-off values for routine use. Keywords: SII; SIRI; cervical cancer; complete blood count; HPV 1. Introduction Cervical cancer remains a global health concern, with incidence increasing in developing countries, largely due to high-risk Human Papilloma Virus (HPV) infections [1,2] . HPV, a common sexually transmitted virus, infects the epithelium of the cervix as well as other anogenital and oropharyngeal sites [3,4] . Cervical cancer usually develops gradually from precancerous lesions called cervical intraepithelial neoplasia (CIN), which ar

FAQs

What are SII and SIRI, and why are they relevant to cervical cancer?

SII and SIRI are indices derived from routine blood count parameters that reflect systemic inflammation and immune response. They are proposed as prognostic biomarkers in cervical cancer research.

How was SII and SIRI evaluated in the study?

The study retrospectively analyzed 344 patients who underwent loop electrosurgical excision for cervical intraepithelial neoplasia, collecting demographic, cytologic, histologic, and laboratory data. SII and SIRI were calculated and assessed using statistical analyses including ROC analyses.

What did the results show about the diagnostic value of SII and SIRI?

Higher SII and SIRI values were significantly associated with higher-grade lesions and invasive carcinoma. ROC analyses indicated good discriminatory performance, with negative predictive values of 96–100%, supporting potential utility as rule-out tools.

Sep 30, 2026

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