Abstract: Objective  To explore the value of neutrophil to lymphocyte ratio(NLR) combined with hemoglobin(Hb) level in predicting the occurrence of uterine fibroids combined with adenomyosis. 
Methods  The clinical data of 167 patients with benign uterine lesions who underwent hysterectomy were retrospectively analyzed. According to the results of histopathological diagnosis, they were divided into simple uterine fibroids group(control group, n=95) and uterine fibroids combined with adenomyosis group(observation group, n=72). Blood routine indexes such as neutrophils count(NEUT), lymphocyte count(LY) and hemoglobin(Hb) level in peripheral blood were detected, and NLR was calculated. The clinical data and biochemical indicators of the two groups were compared. Multivariate Logistics regression was used to analyze the influencing factors of uterine fibroids and adenomyosis. Receiver operating characteristic curve(ROC) was used to assess the predictive value of peripheral blood NLR and Hb levels in  occurrence of uterine fibroids and adenomyosis symptom. 
Results  The proportion of patients with history of diabetes and abortion, serum human epididymal protein 4(HE4), carbohydrate antigen 125(CA125) content, and peripheral blood NLR in the observation group were higher than those in the control group, and peripheral blood LY and Hb level were lower than those in the control group(P＜0.05). Multivariate Logistic analysis showed that serum HE4 content, serum CA125 content, peripheral blood NLR, and peripheral blood Hb level were risk factors affecting the occurrence of uterine fibroids and adenomyosis(OR=1.579, 5.726, 3.669, 1.833 ). The area under the ROC curve(AUC) of NLR, Hb level, NLR combined with Hb level in predicting uterine fibroids and adenomyosis were 0.759(95%CI: 0.681-0.836), 0.776(95%CI: 0.700-0.852), and 0.849(95%CI: 0.786-0.913), respectively. The AUC of NLR combined with Hb level in predicting the occurrence of uterine fibroids and adenomyosis was greater than that of NLR alone and Hb level alone(P＜0.05). 
Conclusion  Peripheral blood NLR and Hb levels are risk factors for the occurrence of uterine fibroids and adenomyosis, which, therefore, can be used as reference indexes for early screening and diagnosis of uterine fibroids and adenomyosis.

Key words: leiomyoma, adenomyosis, neutrophil to lymphocyte ratio