Diagnostic value of systemic inflammatory indices in ectopic pregnancy

This study aims to evaluate the diagnostic and prognostic utility of systemic inflammatory indices in patients with ectopic pregnancy, and to assess whether they may serve as readily obtainable indicators for early diagnosis and informed clinical decision-making. This retrospective case-control study was conducted at Aksaray Training and Research Hospital between January 2020 and November 2025. The study group consisted of 116 patients who underwent surgical treatment for tubal ectopic pregnancy, while 101 healthy pregnant women with similar demographic characteristics and gestational age served as controls. Hematologic and systemic inflammatory indices were calculated and compared in both groups. A statistically significant difference was found between the patient and control groups in terms of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI) values (p<0.05). Comparative analysis revealed no significant intergroup variation in Systemic Inflammation Modulation Index (SIMI) scores (p>0.05). ROC analysis showed that all inflammatory indices except SIMI had statistically significant discriminatory ability. SIRI demonstrated the highest specificity (92.2%) with a PPV of 79.5%, NPV of 61.8%, and the largest AUC (0.68, 95% CI: 0.60–0.75, p<0.001), whereas NLR had the highest sensitivity (97.0%) with a high NPV (91.7%), PPV of 54.1%, and an AUC of 0.66 (95% CI: 0.59–0.73, p<0.001). AISI, SII, and PLR showed moderate diagnostic performance (AUC: 0.60–0.63) with PPV and NPV values ranging between 54–56% and 64–71%, respectively (p<0.05). SIMI did not demonstrate significant predictive value (AUC: 0.53, p=0.399; PPV 69.2%, NPV 56.5%).  The results of the current study highlight the potential role of several inflammatory indices in the clinical assessment of ectopic pregnancy.