r-AFS分期评分联合术前血清IL-6和CA125水平对子宫内膜异位症患者腹腔镜保守性手术后复发的预测价值
| 作者: |
1秦洁
1 皖北煤电集团总医院妇科，安徽 宿州 234000 |
| 通讯: | |
| DOI: | 10.3978/j.issn.2095-6959.2023.221259 |
摘要
目的：探究修订的美国生育协会(revised American Fertility Society，r-AFS)分期评分联合术前血清白细胞介素-6(interleukin-6，IL-6)、糖类抗原125(carbohydrate antigen 125，CA125)水平对子宫内膜异位症(endometriosis，EMT)患者腹腔镜保守性手术后复发的评估价值。方法：回顾性选取2018年3月至2020年4月在皖北煤电集团总医院接受腹腔镜保守性手术治疗的EMT患者120例，并根据其术后2年的预后情况分为复发组(31例)、未复发组(89例)。收集所有患者术后r-AFS分期评分、术前血清IL-6和CA125水平等临床就诊资料，探究其对术后复发的预测价值。结果：术后高r-AFS分期评分、术前血清IL-6和CA125高水平均为EMT患者术后复发的独立危险因素(均P<0.05)。受试者操作特征(receiver operating characteristic，ROC)曲线分析显示：术后r-AFS分期评分、术前血清IL-6和CA125水平均对术后复发具有一定的预测价值(均P<0.05)，且3个指标联合预测的曲线下面积(area under the curve，AUC)最大，为0.973。联合预测的敏感度为90.32%、特异度为97.75%(95% CI：0.926~0.994)。结论：术后r-AFS分期评分、术前血清IL-6和CA125水平联合对EMT患者保守性手术后复发的预测价值较高，对制订术后预防方案具有一定的指导意义。
关键词：
子宫内膜异位症；复发；修订的美国生育协会分期；白细胞介素-6；糖类抗原125；预测价值
Predictive value of r-AFS staging score combined with preoperative serum IL-6 and CA125 levels in the recurrence of endometriosis patients after laparoscopic conservative surgery
DOI: 10.3978/j.issn.2095-6959.2023.221259
Abstract
Objective: To explore the value of postoperative score of revised American Fertility Society (r-AFS) staging combined with preoperative serum levels of interleukin-6 (IL-6) and carbohydrate antigen 125 (CA125) in evaluating the recurrence of laparoscopic conservative surgery in patients with endometriosis (EMT).
Methods: A total of 120 patients with EMT who received laparoscopic conservative surgery in Wanbei Coal and Electricity Group General Hospital from March 2018 to April 2020 were retrospectively selected. According to their 2-year postoperative prognosis, they were divided into a recurrence group (31 cases), and a non-relapse group (89 cases). The postoperative r-AFS staging score, preoperative serum levels of IL-6 and CA125 and other clinical data of all patients were collected to explore their predictive value for postoperative recurrence.
Results: High postoperative r-AFS staging score and high level of preoperative IL-6 and CA125 were independent risk factors for postoperative recurrence in EMT patients (all P<0.05). The receiver operating characteristic curve (ROC) analysis showed that postoperative r-AFS staging score, preoperative serum levels of IL-6 and CA125 had certain predictive value for postoperative recurrence (all P<0.05), and the combined prediction of the 3 indicators had the largest area under the curve (AUC) (0.973). The combined prediction sensitivity was 90.32%, specificity was 97.75% (95% CI 0.926 to 0.994).
Conclusion: The combination of postoperative r-AFS staging score, preoperative serum levels of IL-6 and CA125 has high predictive value for the recurrence of EMT after conservative surgery, and has certain guiding significance for the formulation of postoperative preventive programs.
Keywords：
endometriosis; recurrence; revised American Fertility Society staging; interleukin-6; carbohydrate antigen 125; predictive value
Methods: A total of 120 patients with EMT who received laparoscopic conservative surgery in Wanbei Coal and Electricity Group General Hospital from March 2018 to April 2020 were retrospectively selected. According to their 2-year postoperative prognosis, they were divided into a recurrence group (31 cases), and a non-relapse group (89 cases). The postoperative r-AFS staging score, preoperative serum levels of IL-6 and CA125 and other clinical data of all patients were collected to explore their predictive value for postoperative recurrence.
Results: High postoperative r-AFS staging score and high level of preoperative IL-6 and CA125 were independent risk factors for postoperative recurrence in EMT patients (all P<0.05). The receiver operating characteristic curve (ROC) analysis showed that postoperative r-AFS staging score, preoperative serum levels of IL-6 and CA125 had certain predictive value for postoperative recurrence (all P<0.05), and the combined prediction of the 3 indicators had the largest area under the curve (AUC) (0.973). The combined prediction sensitivity was 90.32%, specificity was 97.75% (95% CI 0.926 to 0.994).
Conclusion: The combination of postoperative r-AFS staging score, preoperative serum levels of IL-6 and CA125 has high predictive value for the recurrence of EMT after conservative surgery, and has certain guiding significance for the formulation of postoperative preventive programs.