Abstract
BACKGROUND: Traditional tumor markers used in testicular cancer diagnosis, such as alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH), present limitations due to variable expression across tumor subtypes. Inflammatory markers derived from complete blood count (CBC), along with C-reactive protein (CRP), have emerged as potential adjuncts for diagnosis and prognosis. This study aimed to evaluate the diagnostic and prognostic utility of CBC-derived inflammatory indices and CRP in patients with testicular cancer. METHODS: We retrospectively analyzed testicular cancer patients, assessing baseline CBC parameters, inflammatory ratios (including neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and systemic immune-inflammation index [SII]), and CRP levels. Their diagnostic accuracy was compared with classical tumor markers, while prognostic implications were assessed through survival outcomes and disease progression. RESULTS: Inflammatory markers, particularly NLR and SII, demonstrated significant associations with tumor burden and advanced disease stage. Elevated CRP levels correlated with poorer prognostic features and worse outcomes. While classical tumor markers remained essential in diagnosis and staging, the integration of inflammatory indices provided additional discriminatory power, especially in patients with normal or equivocal AFP and hCG values. CONCLUSIONS: CBC-derived inflammatory markers and CRP represent promising, cost-effective, and easily accessible tools that complement classical tumor markers in testicular cancer. They offer both diagnostic and prognostic value, particularly in cases where traditional biomarkers are insufficient. Prospective multicenter studies are warranted to validate these findings and incorporate inflammatory indices into routine clinical algorithms for testicular cancer management.