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Peer-reviewedCC BY-NC-ND 4.0BMC Women's Health

Expression and clinical significance of WBC, hs-CRP, and ROMA index, and tumor markers in endometriosis

  1. 1Genetic and Prenatal Diagnosis Center, Putian Maternal and Child Health Care Hospital, The Affiliated Hospital (Group) of Putian University, Putian, China
  2. 2Department of Clinical Laboratory, The Affiliated Hospital (Group) of Putian University, Dongzhen Road 999 Putian, Putian, Fujian 351100 China

Abstract

Purpose: To investigate the expression and clinical significance of white blood cell (WBC) count, high-sensitivity C-reactive protein (hs-CRP), Risk of Ovarian Malignancy Algorithm (ROMA) index, and tumor markers in patients with endometriosis.

Methods: A total of 125 women with surgically and histologically confirmed endometriosis and 80 control women without clinical or ultrasonographic evidence of endometriosis were enrolled at the Affiliated Hospital of Putian University between August 2019 and March 2023. Fasting venous blood samples were collected preoperatively, prior to surgical intervention, to measure WBC, hs-CRP, CA125, HE4, and formula-derived ROMA index values. Statistical analyses included independent-sample t-tests and one-way ANOVA to compare biomarker levels between groups and across surgical procedures.

Results: Compared with controls, patients with endometriosis showed significantly elevated WBC, hs-CRP, CA125, HE4, and formula-derived premenopausal and postmenopausal ROMA index values (all p < 0.001). One-way ANOVA showed no significant differences in biomarker levels across surgical procedures. These findings suggest that inflammatory markers, tumor-associated biomarkers, and formula-derived ROMA values are elevated in patients with endometriosis; however, ROMA findings should be interpreted cautiously because menopausal status was not consistently available for patient-specific ROMA classification.

Conclusion: Elevated WBC count, hs-CRP, CA125, and formula-derived ROMA index values may reflect systemic inflammatory activation in endometriosis, while HE4 should be interpreted more cautiously as a nonspecific tumor-associated biomarker difference. Because menopausal status was not consistently available, ROMA findings should be interpreted as exploratory formula-derived values rather than patient-specific clinical ROMA classifications.

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BibTeX
@article{li2026expression,
  title = {{Expression and clinical significance of WBC, hs-CRP, and ROMA index, and tumor markers in endometriosis}},
  author = {Jiao Li and Kangying Wang},
  journal = {BMC Women's Health},
  year = {2026},
  month = jul,
  doi = {10.1186/s12905-026-04749-9},
  url = {https://doi.org/10.1186/s12905-026-04749-9},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Expression and clinical significance of WBC, hs-CRP, and ROMA index, and tumor markers in endometriosis
AU  - Jiao Li
AU  - Kangying Wang
PY  - 2026
DA  - 2026/07/31
JO  - BMC Women's Health
DO  - 10.1186/s12905-026-04749-9
UR  - https://doi.org/10.1186/s12905-026-04749-9
AB  - Purpose: To investigate the expression and clinical significance of white blood cell (WBC) count, high-sensitivity C-reactive protein (hs-CRP), Risk of Ovarian Malignancy Algorithm (ROMA) index, and tumor markers in patients with endometriosis.  Methods: A total of 125 women with surgically and histologically confirmed endometriosis and 80 control women without clinical or ultrasonographic evidence of endometriosis were enrolled at the Affiliated Hospital of Putian University between August 2019 and March 2023. Fasting venous blood samples were collected preoperatively, prior to surgical intervention, to measure WBC, hs-CRP, CA125, HE4, and formula-derived ROMA index values. Statistical analyses included independent-sample t-tests and one-way ANOVA to compare biomarker levels between groups and across surgical procedures.  Results: Compared with controls, patients with endometriosis showed significantly elevated WBC, hs-CRP, CA125, HE4, and formula-derived premenopausal and postmenopausal ROMA index values (all p < 0.001). One-way ANOVA showed no significant differences in biomarker levels across surgical procedures. These findings suggest that inflammatory markers, tumor-associated biomarkers, and formula-derived ROMA values are elevated in patients with endometriosis; however, ROMA findings should be interpreted cautiously because menopausal status was not consistently available for patient-specific ROMA classification.  Conclusion: Elevated WBC count, hs-CRP, CA125, and formula-derived ROMA index values may reflect systemic inflammatory activation in endometriosis, while HE4 should be interpreted more cautiously as a nonspecific tumor-associated biomarker difference. Because menopausal status was not consistently available, ROMA findings should be interpreted as exploratory formula-derived values rather than patient-specific clinical ROMA classifications.
SN  - 1472-6874
ER  -