Abstract: Objective To explore and evaluate peripheral blood cell parameters and cytokine levels in the differential diagnosis between adenomyosis and uterine leiomyoma. Methods A total of 87 patients with adenomyosis （adenomyosis group) and 87 patients with uterine leiomyoma （uterine leiomyoma group) admitted to Xuzhou Maternity & Child Health Care Hospital from January 2024 to June 2025 were selected as the case group,and another 50 fertile healthy women were selected as the control group. The clinical data of the subjects were collected and reviewed. The general data of the three groups were compared. Flow cytometry was used to detect the expression levels of IL-6, IL-17, tumor necrosis factor-α(TNF-a) and IL-8 in the serum of the three groups. Automatic hematology analyzer was used to detect the following indicators: platelet (PLT)，hemoglobin（Hb)，neutrophil （NEU)，lymphocyte (LYM) and monocyte （MON) in the three groups, and blood cell-derived parameters[neutrophil/lymphocyte ratio （NLR)，neutrophil/monocyteratio (NMR)， platelet/hemoglobin ratio (PHR)】were calculated. Multivariate logistic regression analysis was used to analyze the in- fluencing factors of adenomyosis and uterine leiomyoma. Receiver operating characteristic（ROC) curve was used to evaluate the diagnostic value of IL-6,IL-8 and PHR alone and in combination for adenomyosis and uterine leiomyoma. ResultsThe age，gravidity,levels of IL-6, TNF-a,NEU,NLR and PHR were all higher in both adenomyosis and uterine leiomyoma groups than those in healthy control group(P