Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 20 1 2026 07 22 52 60 Samina Sultana Department of Obstetrics & Gynecology, Dhaka Medical College Hospital, Dhaka-1000, Bangladesh AND Department of Public Health, North South University, Dhaka-1229, Bangladesh Nahid Hassan Nishan Department of Public Health, North South University, Dhaka-1229, Bangladesh 2026 02 20 2026 06 09 Objective: Elevated fibrinogen levels have been associated with tumor progression in multiple malignancies; however, their relationship with lymphovascular space invasion (LVSI) in endometrial carcinoma remains insufficiently characterized. This study investigated the association between preoperative fibrinogen levels and LVSI and evaluated its potential as a preoperative biomarker. Materials and methods: This cross-sectional analytical study included 152 patients with histologically confirmed primary endometrial carcinoma treated between August 2018 and August 2023 at Bangabandhu Sheikh Mujib Medical University and selected private clinics in Dhaka, Bangladesh. Preoperative plasma fibrinogen levels were measured using the Claus method. LVSI status was determined through histopathological examination of surgical specimens. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results: LVSI was identified in 30.3% of patients. Mean preoperative fibrinogen levels were significantly higher in patients with LVSI compared to those without (414.66 ± 117.94 mg/dL vs. 277.27 ± 89.34 mg/dL; p < 0.001). In multivariable analysis, each 100 mg/dL increase in fibrinogen was associated with a 2.34-fold increase in the odds of LVSI (adjusted odds ratio 2.34; 95% confidence interval 1.52–3.60; p < 0.001). ROC analysis demonstrated good discriminatory performance (AUC 0.811; 95% CI 0.729–0.882). An optimal cut-off value of approximately 380 mg/dL yielded 65% sensitivity and 89% specificity. Conclusion: Elevated preoperative fibrinogen levels are independently associated with LVSI in endometrial carcinoma and demonstrate good discriminatory performance. Fibrinogen may serve as a clinically accessible biomarker associated with LVSI and warrants further validation in larger prospective studies. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3673 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3673/753