Inflammatory–Hematological Profiles in Nasopharyngeal Carcinoma and Suspicious Adenoid Hypertrophy: An Exploratory Single-Center Study

Background: Differentiating nasopharyngeal carcinoma (NPC) from benign nasopharyngeal lesions may be challenging because clinical and endoscopic findings can overlap. This study compared routine inflammatory and hematological biomarkers between patients with histopathologically confirmed NPC and patients with suspicious but histopathologically benign adenoid hypertrophy (AH). Methods: This retrospective single-center study included 72 adults evaluated between January 2024 and January 2026: 36 patients with NPC and 36 with AH. Routine hematological and inflammatory variables were compared between groups. After inconsistencies were identified in the originally derived indices, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were recalculated using the available absolute blood-cell-count variables. Receiver operating characteristic analyses and exploratory Firth penalized logistic regression were performed, with histopathologically confirmed NPC coded as the positive outcome. Results: Patients with NPC were younger than patients with AH (38.14 ± 7.64 vs. 56.06 ± 8.29 years; p < 0.001). CRP, ESR, and leukocyte count were significantly higher in the NPC group. PLR was significantly higher in the AH group, whereas NLR and SII did not differ significantly between groups. CRP demonstrated apparent complete discrimination between the two selected diagnostic groups (AUC 1.000), while ESR yielded an AUC of 0.948. In the Firth penalized logistic regression model adjusted for age, sex, and smoking status, each 10 mg/L increase in CRP was associated with higher odds of NPC (adjusted OR 3.16, 95% CI 1.68–16.72; p < 0.001). The addition of CRP increased the model AUC from 0.950 to 1.000. Conclusions: Routine inflammatory markers showed different cross-sectional distributions between patients with node-positive NPC and patients with suspicious benign adenoid hypertrophy. CRP provided incremental discriminatory information in this selected cohort but should not be interpreted as a validated stand-alone diagnostic marker. The findings require prospective external validation in a larger and clinically representative population.