血清标志物在子宫内膜异位症诊断和预后中的价值：一项前瞻性病例对照研究。

The value of serological markers in the diagnosis and prognosis of endometriosis: a prospective case-control study.

机构信息

University of Medicine Gr T Popa Iasi, Romania.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2011 Feb;154(2):215-7. doi: 10.1016/j.ejogrb.2010.10.008. Epub 2010 Nov 13.

DOI:10.1016/j.ejogrb.2010.10.008

PMID:21075501

Abstract

OBJECTIVE

We analyzed selected well-known and less well-known serum markers that have been proposed for diagnosis and severity assessment of endometriosis, in a case-control study.

STUDY DESIGN

This prospective study was carried out in a Clinical Department of Gynecology in Iasi, Romania. Study participants included endometriosis patients, and controls in whom laparoscopy had excluded endometriosis. Each case and control was investigated for serum levels of CA125, TNF, IL-1, IL-6 and IL-8. The data were correlated with clinical symptoms and revised American Fertility Society (rAFS) score and stage, and interpreted by Mann-Whitney U-test and ANOVA regression analysis.

RESULTS

Over the course of 1 year, 24 cases of endometriosis and 24 controls of matched age were selected. The rAFS stages were: stage I, 12.5%; stage II, 16.7%; stage III, 58.3%; and stage IV, 12.5%. CA125 levels were over the cut-off of 35 IU/l in 54% of patients (versus 8% of controls), averaging 67.5 (CI95: ±17.5). The sensitivity and specificity were 54% and 91%, respectively, with a p value of <0.001 (statistically significant). For IL-6, 71% of cases and 87% of controls were above the cut-off of 2 pg/ml, with an average of 11.83 ± 7. The sensitivity and specificity were 71% and 12%, respectively, but the difference was not statistically significant, p = 0.071. Other tested serum markers had no discrimination value. A correlation with severity of endometriosis was seen for CA125 (p = 0.03) but not for IL-6, by ANOVA.

CONCLUSION

CA125 correlated with endometriosis screening and severity, indicating its superiority as a marker for further, larger studies.

摘要

目的

我们在一项病例对照研究中分析了一些已被提出用于诊断和评估子宫内膜异位症严重程度的知名和不太知名的血清标志物。

研究设计

这项前瞻性研究在罗马尼亚雅西的一个妇科临床科室进行。研究参与者包括子宫内膜异位症患者和腹腔镜排除子宫内膜异位症的对照组。对每个病例和对照者进行了血清 CA125、TNF、IL-1、IL-6 和 IL-8 水平的检测。数据与临床症状和修订后的美国生育协会（rAFS）评分和分期相关，并通过 Mann-Whitney U 检验和 ANOVA 回归分析进行解释。

结果

在 1 年的时间里，选择了 24 例子宫内膜异位症病例和 24 例年龄匹配的对照组。rAFS 分期为：I 期，12.5%；II 期，16.7%；III 期，58.3%；IV 期，12.5%。CA125 水平超过 35IU/l 截断值的患者占 54%（对照组为 8%），平均值为 67.5（CI95：±17.5）。敏感性和特异性分别为 54%和 91%，p 值<0.001（统计学显著）。对于 IL-6，71%的病例和 87%的对照组超过 2pg/ml 的截断值，平均为 11.83±7。敏感性和特异性分别为 71%和 12%，但差异无统计学意义，p=0.071。其他测试的血清标志物没有鉴别价值。通过 ANOVA 分析，CA125 与子宫内膜异位症的严重程度相关（p=0.03），但与 IL-6 无关。