Introduction/Background Neutrophil:lymphocyte ratio (NRL) is defined as the absolute neutrophil count divided by the absolute lymphocyte count. NLR reflects relationship between innate (neutrophils) and adaptive cellular immune response (lymphocytes) assessed during various pathological states including endometrial cancer. A normal range of NLR is between 1–2, the values higher than 3.0 in adults are pathological. NLR in a grey zone between 2–3 may serve as early warning of pathological processes such like malignancy.

Methodology A comprehensive literature search was performed on Pubmed’s electronic database using searching the term ’neutrophil to lymphocyte ratio’, ’endometrial cancer’. Clinical data from 2012 to 2023 were reviewed for studies in English language which assessed NLR as a prognostic factor for these patients. The date of last search was set at 10 January 2023. Inclusion criteria include studies assessing NRL of endometrial cancer patients finally treated by radical hysterectomy.

Results Literature search yielded fifteen retrospective studies assessing potential prognostic value of NLR. Seven studies were excluded from the present systemic review because they did not meet the inclusion criteria.

Nine studies were included finally in the systemic review. A total of 3162 patients were analyzed in these studies which were conducted in Europe and Asia. Blood NRL assessment was performed before surgical intervention. All histophatological types of endometrial cancer were included in these studies.

Seven out of nine studies showed that NLR was significantly raised among patients with endometrial cancer and found a significant association of higher NLR with advanced stages of endometrial cancer. On the contrary, two studies did not show significant correlation between higher NLR and advanced stages of endometrial cancer.

Conclusion NRL can be used as a tool in prediction of the advanced stages of endometrial cancer. Further prospective studies are needed to establish the exact value of NLR to predict advanced stages of endometrial cancer.

Disclosures No conflict of interest