Diagnostic value of the pan-immune-inflammation value, plateletcrit, and monocyte count in salivary gland tumors: a 10-year two-stage retrospective analysis.

purposeIn this study, we aimed to evaluate the diagnostic contribution of routine clinical and hematological parameters and inflammation-based indices, including the pan-immune-inflammation value (PIV) and plateletcrit (PCT), to salivary gland tumors using a two-step approach for benign–malignant discrimination and pleomorphic adenoma versus Warthin’s tumor classification.

methodsThis retrospective study included 216 parotid/submandibular gland tumors surgically treated between 2015 and 2025. Benign and malignant tumors were compared in the first stage, followed by pleomorphic adenoma versus Warthin’s tumor analysis. ROC analysis and multivariate logistic regression were performed.

resultsOf 216 tumors, 189 (87.5%) were benign and 27 (12.5%) were malignant. Malignancy was more frequent in females and non-smokers and was associated with shorter symptom duration and lower hemoglobin levels. Hemoglobin (AUC = 0.719) and symptom duration (AUC = 0.632) had limited clinical utility due to low specificity. In the second-stage analysis (pleomorphic adenoma, n = 94; Warthin’s tumor, n = 71), Warthin’s tumor was associated with older age, male sex, smoking, and parotid origin. Age had the highest discriminative performance (AUC = 0.739). In multivariate analysis, age and smoking remained independent predictors, and monocyte count provided an additional independent contribution. Inflammation-based indices, including PIV and PCT, did not display statistically significant between-group differences in either comparison.

conclusionInflammation-based indices, including PIV and PCT, did not provide significant diagnostic discrimination in this study. Monocyte count may offer incremental utility for pleomorphic adenoma versus Warthin’s tumor classification and warrants validation in larger, histology-specific series.