Relationship between High C-Reactive Protein Levels and Neutrophil Lymphocyte Ratio in Epithelial Ovarian Cancer

Background: Epithelial ovarian cancer (EOC) remains one of the most lethal gynecological malignancies owing to difficulties in its early detection. Although CA-125 and HE-4 are commonly used biomarkers, their limited sensitivity, specificity, availability, and cost restrict their clinical application. Inflammatory markers such as C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR), which are routinely measured and inexpensive, have been proposed as potential indicators associated with malignancy. However, evidence regarding their relationship to epithelial ovarian cancer, particularly in Indonesia, remains limited. Methods: This observational study used a cross-sectional design. Sixty ovarian cancer patients who met the inclusion and exclusion criteria and were treated at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, were included. Data on pre-treatment CRP levels, NLR values, and histopathological findings were obtained from medical records. Associations between CRP, NLR, and epithelial ovarian cancer were analyzed using the chisquare test, while the correlation between CRP and NLR was assessed using Spearman’s correlation test. Statistical significance was set at P